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A newsletter from Ankle & Foot Care Centers.

Fourth Quarter 2015 Edition:

Care Halts Gangrene, Saves Local Businessman's Foot

Last year, a rapid spread of dangerous gangrene to his feet almost forced Dan Cavanaugh of East Palestine to have his left foot removed.

But after cardiovascular surgery by a local surgeon and five months of appointments with Dr. Gregory Blasko, Dan enjoyed a rapid recovery and wound up losing only a small part of one toe.

Moreover, after several weeks of immobility, he can now walk around comfortably, just as he did before the condition set in and prompted his second surgery in a span of a few weeks.

“I feel like the surgeon saved my life and Dr. Blasko kept it going,” said Cavanaugh, 61, who runs a local transportation safety business and likes to golf and fish. “I’m able to do everything I did before, which is very nice.”

One day last year when Dan was showering, he noticed three dark marks on his left foot, each about the size of a pencil eraser. On a reference from his family doctor, he consulted Dr. Blasko, who identified gangrene and set up an appointment a week later for a debridement, a removal of unhealthy tissue to promote healing.

But in that interim week, the gangrene spread rapidly. Dan said his largest and smallest toes “turned almost completely black,” and other toes on both feet also showed signs of gangrene.

The situation was so severe that amputation was considered. But one last strategy to preserve the foot wound up working.

As Dan relates, the gangrene was ironically related to his first cardiovascular surgery just a few weeks earlier, which cleared a blocked artery in his abdomen and placed a stent there to keep that artery open. Plaque from that location apparently collected quickly in Dan’s feet, he said.

To halt the spread of gangrene in the feet, Dan underwent a second surgery, this time to insert a stent in his aorta to trap plaque against the vessel wall and prevent buildup elsewhere. This procedure successfully stopped the gangrene’s progress, and further treatments in the hospital and in Dr. Blasko’s office helped heal the damage that was already done.

“I was in the hospital for eight days, and it was a scary time,” Dan recalled. “When you take someone who’s active and put him in a place where he can’t move … it’s hard to even imagine. Also, I had to wait for several tests to make sure the gangrene wasn’t being caused by some terrible disease.

“It felt like I had a giant scab on my foot, and it had a horrific smell,” he added. “I couldn’t walk on it, so I had to get around with crutches and a wheelchair.”

He saw Dr. Blasko weekly from April through September of last year, and the gangrene – on both feet – slowly got better and better. So did Dan’s mobility. However, he did have to have the tip of his left toe removed.

Much of the credit for Dan’s recovery goes to his wife, Carol, who tended to him daily, sometimes changing his dressings multiple times a day.

He said Dr. Blasko’s diligence with the weekly treatments gave him hope for his feet, and the doctor’s daily visits in the hospital helped him through a frightening period.

“He came to visit me every day and, to me, that’s phenomenal,” Dan said. “A lot of times, you’re treated like a number. He can do no wrong as far as I’m concerned.”

Copyright © December 2015 Ankle & Foot Care Centers

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Ankle & Foot Drive Welcomes Shoes, Socks for Needy

Ankle & Foot Care Centers has launched its 18th annual holiday shoe and sock drive and hopes to deliver more than 500 pairs of shoes and more than 800 pairs of socks to local residents through the Salvation Army early next year. Read more here.

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Easy Measures for Discouraging Athlete's Foot

Severe cases of athlete's foot, officially known as tinea pedis, can require advanced treatment. But many cases of the common condition can be prevented with some easy measures, says Dr. David Podolsky, a podiatric physician and surgeon with Ankle & Foot Care Centers in Youngstown, Ohio. Read more here.

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Treatments Save Coitsville Man's Foot from Amputation

An ulcer on the bottom of Donald Chatham’s right foot got so bad year that he almost had to have the foot amputated.

But a combination of treatments under the care of Dr. Kenneth Emch of Ankle & Foot Care Centers enabled Donald, now 62, of Coitsville, to not only save his foot but to walk again without pain.

“It was a long process, but I’m glad I didn’t lose my leg,” Donald said.
In 2013, Donald’s developing ulcer grew dramatically worse when he got it wet while feeding his horses.

“My feet got wet, and I didn’t change my shoes or socks right away,” he recalled. “That caused bacteria to develop, and I got a severe infection.”

The wound eventually grew to the size of a silver dollar, and was so deep that bone and tendons were visible. Donald became confined to a wheelchair and, eventually, a nursing home, to avoid walking on the wound.

The path back to health began when Dr. Emch, a certified wound specialist, ordered hyperbaric oxygen treatments. Those sessions expose wounds to high levels of oxygen, under high pressure, often speeding the healing process.

The treatments worked for Donald, and so did follow-up care with a vacuum assisted closure, often called a wound VAC, which draws fluid away from wounds to promote healing.

A callus has developed where the painful ulcer used to be, and Donald visits Dr. Emch regularly for its management.

“The pain is totally gone,” he said. “I can cut grass, walk around, clean the house and do all of the things I was able to do before without any pain.”

Copyright © December 2015 Ankle & Foot Care Centers

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Dr. Debiec Talks About Diabetes on Channel 21 News

In a recent segment on WFMJ TV Channel 21 News, Dr. Robert Debiec talked about the high risk of amputation for people with diabetes and the importance of podiatric care to reduce that risk. Click the picture or this link to see the story by Channel 21's Kate Keller. 

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Golf Benefit Raises $14,500 for Diabetes Resources

The Ankle & Foot Care Centers 2015 Diabetes Golf Benefit raised $14,500 for two organizations that provide diabetes education and resources. Dr. Michelle Anania, right, recently presented a check for $12,000 to the Diabetes Partnership of the Mahoning Valley, represented here by president Ed Hassay.

Another $2,500 was donated to the American Diabetes Association Northeast Ohio Office. Read more here.

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Dr. Smesko Enjoys Family Time, Food Reviews

Although he keeps a busy schedule with patients at four offices, Dr. Mark Smesko still manages to make family time a priority.

He and his wife Andrea are parents of three young children who are all involved in music and sports, and he is their greatest fan.

"I love spending time with my family and try every day to be home for dinner or at my kids’ various activities," Dr. Smesko said. "We're running all the time. We also like to travel with the kids as much as we can."

His daughter, Taylor, age 11, plays softball. His son Dylan, 9, is active in baseball and swimming, and his son J.D., 7, plays soccer. All three play piano.

Andrea works part-time in information technology for the Columbiana schools, keeps busy with the kids’ school activities and enjoys exercising.

The Smeskos live in Canfield and enjoy trips to the museums, zoos and other attractions in nearby Cleveland and Pittsburgh.

Dr. Smesko has been with Ankle & Foot Care Centers since 1999. Like his colleagues, he sees a broad range of ailments and conditions of the feet and ankles.

“I enjoy treating kids and see a fair amount of them for various problems such as warts, ingrown nails, trauma, flat feet, etc.,” he said. “I treat a lot of diabetic patients for palliative foot care as well as wound care. I enjoy preventative care in diabetics and trying to reduce their risk of complications.”

He also sees a lot of heel pain in both children and adults, and points out that in about 95 percent of cases, improvement occurs without surgery.

“I like podiatry because we can resolve people’s problems -- in some cases in just a few visits,” Dr. Smesko said. “It's rewarding when patients return for a follow-up and tell me they are pain-free. I have always tried to treat patients as I would my own family.”

When he’s not with his family or patients, Dr. Smesko can often be found with food. He loves to cook and has become somewhat of a local celebrity through the “Signature Dishes” column he writes in The Vindicator with Ankle & Foot practice administrator Mike Vallas.

The duo, known as the “Brothers in Food,” publishes reviews and photos in the paper’s food section each month. They also share their handiwork on Twitter at @BrothersinFood.

Photo: Dr. Smesko, Andrea and, from left, Taylor, Dylan and J.D.

Copyright © December 2015 Ankle & Foot Care Centers

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Austintown Medical Assistant Loves Family Environment

Jaime Sanchez transitioned from flight attendant for U.S. Airways to head medical assistant at Austintown Ankle and Foot Care Center 12 years ago. She has never looked back.

“It’s very important to me here that everything is family oriented,” she said. “Everybody wants to know if you need help with anything inside or outside work and my co-workers are very supportive,” said Jaime, who describes herself as a “people person.”

She said patient interaction is just one of the many things she enjoys about her work, which includes dispensing and explaining durable medical equipment such as walking boots and ankle braces to patients. “It’s everything to help them get through their issues,” she said.

“I love to listen to them talk about themselves, especially the elderly,” Jaime said. “Often they’re alone so they relate to those of us who have been here the longest because they know we know them well.”

Jaime said she enjoys working closely with the physicians whom she updates. “First, we bring the patient back and follow-up to see if everything is working out and if they are improving,” she said. Jaime provides the information to the doctor before the consultation begins.

Jaime lives in Salem with Shawn, her husband of 11 years, and Willow, “my cat with blue eyes.” She leads an active life away from work and lists working out and exercising among her passions. Those workouts include kickboxing and spinning classes. She also is an avid runner who has participated in 5K and 10K runs.

Jaime said she likes to travel, which is understandable given her flight attendant background, but lately has limited her journeys to a condominium in Marco Island, Fla., where she and her husband vacation several times a year.

But it’s her work that she finds fulfilling on a daily basis no matter the task. “This is a family environment here for all of us and our patients, and that’s why I enjoy it,” she said.  

Copyright © December 2015 Ankle & Foot Care Centers

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Charcot Foot Patient Gets Back on Her Feet Again

Recovering from a broken foot can be painful and difficult. So just imagine going through that process every year or two. This was a way of life for Shirley Freeland, who suffered from the effects of Charcot foot. But not anymore.

This condition causes the weakening of the bones in the foot that can occur in people who have significant nerve damage, known as neuropathy. The bones are weakened enough to fracture, and with continued walking the foot eventually changes shape. As the disorder progresses, the joints collapse and the foot takes on an abnormal shape, such as a rocker-bottom appearance.

Charcot foot develops as a result of neuropathy, which decreases sensation and the ability to feel temperature, pain, or trauma. Because of diminished sensation, the patient may continue to walk —making the injury worse.

“I was in severe pain,” said Shirley. “My left foot would spontaneously break every two years or so. I’d just get to the point where I’d be healed up, then I’d break it again. I had to wear casts from my ankle down and couldn’t put any weight on it. It was frustrating.”

After years of dealing with the agony and frustration of a broken foot and limited mobility, Shirley finally received some positive news. Her local podiatrist in Steubenville told her about Dr. Lawrence DiDomenico at Ankle & Foot Care Centers. He recommended some procedures that could provide relief and prevent future bone breaks.

In the fall of 2012, Dr. DiDomenico performed a procedure to lengthen the tendons in Shirley’s left foot. Soon after, he reconstructed her ankle and inserted pins into her foot to stabilize it.

“It took a lot of procedures, but what Dr. D did worked well,” explained Shirley. “What he told me would happen, happened. I’m pleased with the mobility I have now. I’m extremely pleased with how he took care of me.

“I did have some infections because of the hardware in my foot, but he explained everything to me and was open and honest. I wasn’t ever going to give up and now because of Dr. D, I feel sensational. He really came through for me, and I’d recommend him to anyone having ankle or foot problems.”

Copyright © December 2015 Ankle & Foot Care Centers

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Cold-Weather Foot Care Tips for Winter

Winter Whether this winter winds up mild or harsh, it’s important to take care of your feet all winter long. You want them to be healthy and ready for action when Spring arrives.

The American Podiatric Medical Association (APMA) offers some advice for keeping feet healthy in common winter scenarios:

Safe skiing & snowboarding: Nearly 10 million Americans enjoy these activities, according to the National Ski Areas Association. Never ski or snowboard in footwear other than ski boots specifically designed for that purpose.

Make sure your boots fit properly; you should be able to wiggle your toes, but the boots should immobilize the heel, instep, and ball of your foot. You can use orthotics (support devices that go inside shoes) to help control the foot’s movement inside ski boots or ice skates.

Running in the cold: Committed runners don’t need to let the cold stop them. A variety of warm, lightweight, moisture-wicking active wear available at most running or sporting goods stores helps ensure runners stay warm and dry in bitter temperatures.

However, some runners may compensate for icy conditions by altering how their foot strikes the ground. Instead of changing your foot-strike pattern, shorten your stride to help maintain stability.

And remember, it’s more important than ever to stretch before you begin your run. Cold weather can make you less flexible in winter than you are in summer, so it’s important to warm muscles up before running.

Importance of good boots: Between the waterproof material of the boots themselves and the warm socks you wear to keep toes toasty, you may find your feet sweat a lot.

Sweaty feet can chill more easily and are more prone to bacterial infections. To keep feet clean and dry, consider using foot powder inside socks and incorporating extra foot baths into your foot-care regimen this winter.

Make sure they fit: It may be tempting to buy pricey specialty footwear (like winter boots or ski boots) for kids in a slightly larger size, thinking they’ll be able to get two seasons of wear out of them.

But unlike coats that kids can grow into, footwear needs to fit properly right away. Properly fitted skates and boots can help prevent blisters, chafing, and ankle or foot injuries.

Likewise, if socks are too small, they can force toes to bunch together, and that friction can cause painful blisters or corns.

Finally -- and although this one seems like it should go without saying, it bears spelling out -- don’t try to tip-toe through winter snow, ice, and temperatures in summer-appropriate footwear.

Copyright © December 2015 Ankle & Foot Care Centers

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From The Kitchen: Mini Salmon Cakes with Cucumber Aioli

From The Kitchen

(From the Kitchen recipes are diabetic-friendly and provided by the Diabetes Partnership of the Mahoning Valley)

  • 1/2 cup finely chopped cucumbers
  • 6 Tbsp. Miracle Whip Calorie-Wise Spread, divided
  • 1/4 cup chopped fresh chives, divided
  • 2 tsp. zest and 1 Tbsp. juice from 1 lemon, divided
  • 1 skinless salmon fillet (1/2 lb./225 g), finely chopped
  • 2 Tbsp. dry whole wheat bread crumbs
  • 1 tsp. grainy Dijon mustard
  • Mix cucumbers, 1/4 cup (4 Tbsp.) dressing, 1 Tbsp. chives, 1 tsp. lemon zest and 2 tsp. lemon juice until blended. Refrigerate 30 min. Combine all remaining ingredients; spoon into 8 mounds, 3 inches apart, onto foil-covered baking sheet, using about 2 Tbsp. salmon mixture for each. Flatten each to 1/2-inch-thick patty.
  • Heat broiler. Broil patties, 4 inches from heat, 3 to 5 min. or until salmon cakes are done and tops are golden brown. Serve topped with cucumber mixture.


  • 8 servings, 1 salmon cake (34 g) and 1 Tbsp. (15 mL) aioli each


  • Prepare cucumber and salmon mixtures as directed, doubling all ingredients; use to make 16 mini salmon cakes. Or, shape salmon mixture into 4 (1/2-inchthick) patties. Broil 7 to 10 min. or until done. Serve salmon burgers on lettuce-covered whole wheat bread slices or in sandwich buns topped with cucumber mixture.

Copyright © December 2015 Kraft Foods 

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