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A newsletter from Ankle & Foot Care Centers.

Third Quarter 2020 Edition:

Causes and Solutions for Ball-of-Foot Pain

By: Dr. Jennifer Flo of NOMS Ankle & Foot Care Centers

Pain in the ball of the foot is generally called metatarsalgia, a common over-use condition in which your foot becomes painful and inflamed. Understanding the cause will influence which treatment method might be most effective.

Read Dr. Flo's blog article here.

Copyright © October 2020 Ankle & Foot Care Centers

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From Back Injury to Toe Amputation: Man is Grateful for Attentive Care During Quick Turn of Events

In just three weeks, Jon Miller went from receiving physical therapy for a back injury, to recovering from an amputation of two of his toes. Despite these unforeseen circumstances, he's still thankful for his team of doctors, including Dr. Ramy Fahim of NOMS Ankle & Foot Care Centers.

After completing two weeks of physical therapy for his injured back, Jon was diagnosed with critical limb ischemia, a severe blockage of the arteries in the lower extremities that causes reduced blood flow. It presents an immediate high risk for limb loss.

"I was being treated for four bulging discs, which we later came to find out were pinching arteries and cutting off blood flow to my feet and toes," said Jon. "My toes started to turn black so my physical therapist referred me to Dr. Fahim. As soon as I got to his office, he sent me to the hospital.

"He quickly put together a team of doctors for me, which was phenomenal, because it all happened so fast," he added.

The Kinsman man, 38, underwent surgery with a vascular surgeon to have blood clots removed in four different places in his femoral artery.

"They got the blood flowing again, and everyone thought I was going to need to have three toes removed," said Jon. "But Dr. Fahim had other plans. He wanted to save the third toe and so far, he's been able to do so."

Dr. Fahim performed an amputation of two toes on John's left foot. After 21 staples and 18 stitches, he's back to walking, but understands there is still a long recovery process ahead.

"I was sent home from the hospital in a shoe and Dr. Fahim swapped it out for a boot, which has been phenomenal," he said. "I can walk much better now."

The father of four is optimistic about his road to recovery.

"I drive a truck for a living," he said. "I know things are likely going to be different, and I'm not sure when I'll be back to work because I'm still dealing with my back injury, too. I'm just thankful that things have turned out the way that they did. I could've lost my entire foot."

Jon continues to receive care from Dr. Fahim at NOMS Ankle & Foot Care Centers' Warren office.

"I'm so grateful for Dr. Fahim and appreciate his down-to-earth, straight-forward and attentive care," he said. "He's my kind of doctor and tells you as it is. Sara Sadeghi, the resident physician working alongside him, is just as awesome. I can't say enough about them. The office staff is great, too. They get you in and out and I've had a really positive experience with the whole team."

Copyright © October 2020 Ankle & Foot Care Centers

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Dr. Fahim Enjoys Taking on Challenging Cases, Helping Patients Return to High Quality of Life

When Dr. Fahim isn't working, he enjoys being a dog dad and spending time with his pup, Tyson.

Dr. Ramy Fahim isn't afraid of taking on a challenge - in fact, much of his work involves treating patients with complicated conditions.

"I pride myself on taking care of patients with challenging conditions, because nothing gives me more satisfaction than seeing a patient recover and enjoy a high quality of life," said Dr. Fahim, podiatric physician, surgeon and wound care specialist. "I am especially passionate about limb salvage and working with diabetic patients to treat wounds."

Dr. Fahim treats patients with a wide variety of foot and ankle ailments, but his work is focused on reconstructive foot and ankle treatment, including fixing bunions and flat feet, and treating arthritis. His expertise is often leveraged for wound salvage and treating diabetic ulcers.

Notably, he also is one of two podiatric surgeons in the area who performs ankle replacement surgery. The other is his colleague, Dr. Lawrence DiDomenico, NOMS Ankle & Foot Care Centers podiatric physician and surgeon.

"Just today, we did an ankle replacement for a man who came in from West Virginia," said Dr. Fahim. "We have patients from Pennsylvania, West Virginia and all across Ohio who come to Youngstown for this surgery because very few podiatric surgeons specialize in it."

Dr. Fahim enjoys the balance between clinical and surgical work. During a typical week, he spends four and a half days treating patients at NOMS Ankle & Foot Care Centers' Warren, Niles and Andover offices, as well as at St. Joe's wound care center. Then, at least one to two days a week, he performs surgeries and visits patients at the hospital.

"One of the reasons I was drawn to podiatry is because of the variety of day-to-day work," said Dr. Fahim. "I explored many medical specialties and enjoyed shadowing different doctors, but I enjoy the balance and flexibility that come with podiatry."

Among his professional accomplishments, Dr. Fahim was recently voted to be section chief of podiatric surgery at St. Elizabeth Mercy Health Hospital in Youngstown. In this role, he will oversee and manage the overall function of the podiatric surgery department and will serve as its representative at meetings and events.

He also recently authored and published a paper in a peer-reviewed medical journal, Clinics of Podiatric Medicine and Surgery, on the use of a novice technique for covering soft tissue defects or ulcers in the feet.

Over the course of four and half years with NOMS Ankle & Foot Care Centers, Dr. Fahim is thankful for his professional experiences in the office, hospital and community.

"I'm grateful for the reputation we've built and the trust that we've earned in our community amongst patients, peers and other healthcare providers," said Dr. Fahim.

"I'm also very proud of our fantastic staff and caring physicians who always work to accommodate patients," said Dr. Fahim. "We have a very unique family-oriented practice with tight-knit relationships between our staff, which rubs off on our patients, too. It becomes contagious. You can see it and appreciate it, but it can't be replicated."

Born and raised in Toronto, Canada, Dr. Fahim moved to Northeast Ohio in his early twenties for medical school and says it has become a second home to him.

After completing a fellowship with NOMS Ankle & Foot Care Centers, Dr. Fahim practiced briefly in Naples, Florida. Upon his return to Youngstown, he said he was "openly embraced and welcomed home" by his colleagues at NOMS AFCC.

When he's not working, he enjoys being a dog dad and spending time with his pup, Tyson. They take frequent walks in our local parks and enjoy weekly trips to Edgewater Park in Cleveland.

Dr. Fahim also enjoys exercising, which he says helps him balance out his passion for pasta and other dishes from local restaurants that he frequents often as a "foodie" who loves the restaurant scene.

"I'm also blessed with an amazing family and close friends who have supported me from day one, despite my busy schedule," said Dr. Fahim.

Copyright © October 2020 Ankle & Foot Care Centers

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Medical Assistant Gains Second Family at Work, Thrives on Building Relationships

Antonietta Lightner had dreams of pursuing a career in the medical field from a young age, but it wasn't until later in life that she saw it through and became a medical assistant and X-ray technician.

The stay-at-home mom of two, a five-year-old daughter and a 15-year-old son, decided to go back to school in her late 30s. She received her medical assistant certificate and x-ray license seven years ago, and has been working with NOMS Ankle & Foot Care Centers in Poland ever since.

She's thankful to be doing what she loves, but what she didn't realize when she first started was that she'd gain a second family, too.

"I never thought I'd have a job where I could build so many wonderful relationships," she said. "Everyone is family here. After all, we spend more time at the office than we do at home. It's nice to have the great care and support we have for each other."

In her role, Antonietta interacts with physicians and patients on a daily basis. Her responsibilities include discussing patient care and medical history and assisting with examinations, procedures and follow-up care. She also takes X-rays, updates medical records and answers patient phone calls.

"Our physicians really take their time with our patients, giving them the concern and attention they deserve," she said. "It's great to see that, and I'm glad to be a part of such a caring organization."

Antonietta also enjoys building relationships through her daily interactions with patients, too. Much of her motivation for this role is fueled by her compassion for elderly people.

"From the moment I greet patients at the door, to when I ask them questions during exams and perform follow-up care, I'm always trying to get to know my patients," she said. "Seeing their smiles and how happy and comfortable they are is really wonderful. They get excited to see me. It makes me feel really good that I'm there."

Antonietta's deep appreciation for cultivating relationships took on new meaning a year and a half ago, when she had to take time off for a medical procedure of her own.

"It broke my heart on my last day of work before my surgery to know that I might not have those same interactions with my patients and coworkers afterward," she said. "I had to have brain surgery and they weren't sure if I'd be able to speak after. I thankfully made a full recovery and am so grateful to be back at work doing what I love."

When she's not at work, she can be found spending time with her family, cooking and reading.

"Our weekends are spent with family," she said. "When my parents come home from Florida in the summer, we spend all of our free time at Lake Berlin, boating and swimming. We're very family-oriented."

Her strong ties to family date back to when she'd spend the summers with her grandparents in Italy from the time she was five until she was 22. That's where she picked up some of her favorite family recipes, too.

"Everything I cook is Italian," she said. "We make everything homemade. It's fun to teach my kids, too. I'll walk into the kitchen to find my 12-year-old and 22-year-old making homemade pasta together."

Whether it's at home or at the office, Antonietta can always be found strengthening her relationships and growing her "family."

Copyright © October 2020 Ankle & Foot Care Centers

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New Middletown Man Suffers from Gangrene, Nearly Loses Toes, Walking Again

As a diabetic who suffers from neuropathy and other underlying health conditions, John Beard is no stranger to challenges. Against all odds, he's thanking Dr. John Chiaro of NOMS Ankle & Foot Care Centers for helping him overcome his most recent obstacle - gangrene on both of his feet.

In April 2019, John, 84, was hospitalized after being diagnosed with Influenza A. After spending time in a long-term care hospital, his wife, Carol, noticed he had developed gangrene on his feet. He was then sent to Masternick Memorial Health Care Center, where he would receive daily wound care.

That was when he began receiving treatment from Dr. Chiaro - but it wasn't his first time meeting him.

"We lived in the same neighborhood as the Chiaro family and our kids grew up playing with Dr. Chiaro and his sister," recalled John's wife. "When I heard that we were going to have him as a doctor, I was so thrilled and immediately felt comforted. I'll never forget the moment I saw him coming down the hall, I said, 'Oh my gosh, it's little Johnny Chiaro!' It's been nearly 40 years since we've seen him, but boy are we glad that we were reunited."

In September of last year, John was sent home from Masternick, but still visited Dr. Chiaro weekly to receive care.

After more than a year of treatment, he is now without gangrene and still has all of his toes.

"When I look at his feet now and remember how they used to be, it's hard for me to believe how far we've come," said Carol. "He's able to walk much better now, and although he still uses a cane and a walker, he doesn't have huge dressings on his feet that prevents him from getting around."

John enjoys being able to visit with friends and hang out on his enclosed porch.

"Even during the height of the pandemic, we have been very impressed with the office and staff at NOMS Ankle & Foot Care Centers," Carol said. "John suffers from diabetes and lymphocytic leukemia and has had heart surgery in the past, so we were fearful to leave home during the peak of COVID-19. We did several tele-health appointments with Dr. Chiaro, but we also had to go into the office for him to do debridement. I can honestly say we always felt safe."

"It's been a challenging time but we give all of the credit to Dr. Chiaro for his excellent care," added Carol. "John is still receiving treatment, but his feet are nearly completely healed."

Copyright © October 2020 Ankle & Foot Care Centers

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Routine Foot Care Helps Woman with Arthritis, Flat Feet, Ingrown Toenails

From the moment she stepped foot into NOMS Ankle & Foot Care Centers' Austintown office, Gloria Fedor felt at home. She began seeing Dr. Michelle Anania several years ago and she's glad she did.

The 80-year-old Canfield woman had been to several podiatrists in the past to treat her arthritic, flat feet and ingrown toenails. It wasn't until her daughters recommended going to Dr. Anania that she began to experience relief.

"We talk like we've known each other for years," said Gloria. "Of all the foot doctors I've been to, I like her the best. She really tries to help."

In addition to her regular foot care, Gloria began going to Dr. Anania for nail care, too.

"My feet feel much better," she said. "I can even walk better now.

"I actually enjoy going to the foot doctor now," Gloria added. "Dr. Anania has a nice personality and really makes you feel at home."

Copyright © October 2020 Ankle & Foot Care Centers

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From the Kitchen: Diabetic-Friendly Chicken Chili

From The Kitchen

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

This chili is packed with vitamin C, protein and fiber and is the perfect fall dinner when you're craving something hearty but healthy. It's also quick, easy and budget-friendly!

Serving size: 4
Diabetic Friendly: Yes

8 oz chicken breasts (boneless, skinless, diced)
1 green pepper (diced)
1 small onion (diced)
1 clove garlic (minced)
2 cans diced tomatoes (14.5 oz)
16 oz navy or great northern beans (rinsed and drained)
1/4 tsp black pepper
2 tsp chili powder
1/2 tsp cumin

Spray a large soup pot with cooking spray. Add chicken and saute over medium heat for seven minutes or until done. Remove chicken from the pan. Add onions and green peppers and saute over medium-high heat for three minutes or until onions are clear. Add garlic and saute 30 more seconds. Add remaining ingredients, including the chicken, and bring to a boil. Reduce heat and simmer for 15 minutes. Enjoy!

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

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