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A newsletter from Ankle & Foot Care Centers.

August 2009 Edition:

Local Podiatrists Unveil New Newsletter

Advice for your feet and ankles and stories about patient recoveries from serious foot problems will be the focus of a new local e-newsletter.

The physicians and surgeons at Ankle & Foot Care Centers, the area’s largest provider of podiatric care, today announced the launch of Ankle & Foot Care Update, a free newsletter distributed by email.

“Because of the many recent advances in the care of the foot, there are many very good stories to tell,” said Dr. Lawrence D. DiDomenico, managing partner at the Ankle & Foot Care Centers.

“We are very fortunate to have patients who want to talk about their recoveries. Also, our doctors want to provide information that helps people be proactive about the care of their feet and ankles.”

Subscription to the newsletter is free to anyone who provides an email address. More information is available at the Newsletter page on the Ankle & Foot Care Web site.

Copyright © August 2009 Ankle & Foot Care Centers

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Nerve Procedure Sparks Recovery from Pain

Agnes GregoryFor most of the past seven years, Agnes Gregory of Lisbon struggled with severe “neuropathy” in her feet. She felt acute pain or a frustrating tingling sensation whenever she was not walking or otherwise using her feet.

Most days, the pain was severe. Every night, she would put an ice pack on her feet to address the pain, just to get through the night. Yet she almost never enjoyed a full night’s sleep.

But in late 2008, Dr. Joseph Francisco Jr., a podiatric physician and surgeon with Ankle & Foot Care Centers, suggested a nerve decompression surgery to address her neuropathy. “He was very convinced that it would work, and I said I’d try anything to get rid of this pain,” Agnes recalled.

The procedure did work, and Agnes has been very thankful for the dramatic change in her life. Since the day after the surgery, the pain and tingling in her feet have been completely gone. No more pain medication and no more ice packs in bed.

“The change has been like night and day – very dramatic,” Agnes said. “It was wonderful.”

Following her recovery, Agnes agreed to share her recovery with the local media, and was interviewed by both The Vindicator and Channel 21. The newspaper published her story on Thanksgiving Day and the television station broadcasted it shortly thereafter.

“Nerve decompression surgery is not for everyone, but it can be very effective in a short period of time for patients that are good candidates for it,” Dr. Francisco said. “In fact, the benefits are typically immediate.”

The goal of the surgery is to restore blood flow to the nerves and reduce the swelling, ending the numbness and tingling that neuropathy patients like Agnes often feel.

Dr. Francisco is one of several surgeons at Ankle & Foot Care Centers who perform the nerve decompression procedure. For more information, contact the office.

Copyright © August 2009 Ankle & Foot Care Centers

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Summer Brings Time to Show Your Toes

Summer is the time for sandals and flip-flops. But corns and calluses that may have developed over the winter could make your feet not quite ready for “prime time.” Help is on the way.

Corns and calluses are protective layers of compacted, thick, dead skin cells. They are caused by repeated friction and pressure from skin rubbing against bony areas or against an irregularity in a shoe. Corns ordinarily form on the toes, and calluses on the soles or the balls of the feet.

Corns and calluses can also form when the position of the bones in your feet change. The corns and calluses initially form to provide protection, but as they thicken, they can become painful and inflamed.

Summer Brings Time to Show Your ToesThe friction and pressure from both corns and calluses can cause a painful or burning sensation. Often one visit to your podiatrist can be all that’s needed to relieve the pain, although most corns and calluses will reoccur without regular monitoring or changes in either your shoes or your foot function. The podiatric physician can work with you to relieve the pain by using a variety of pads or materials on the affected areas.

It is important that you never cut your corns or calluses with any instrument and never apply home remedies, except under a podiatrist’s instructions. Many over-the-counter remedies are advertised frequently, but often these home remedies can be dangerous. Self-treatment can often turn a minor problem into a major one.

Corns and calluses can be particularly problematic for patients with diabetes. These patients should always schedule regular yearly visits with their podiatrists to check for foot problems and circulation issues. If more frequent visits are required, your podiatrist will work with you to make sure your corns and calluses are monitored and treated as needed.

One way to control corns and calluses is to make sure that your shoes fit properly. Buy new shoes later in the day when feet tend to be at their largest and replace worn-out shoes as soon as possible. Select and wear the right shoe for the activity that you are engaged in (i.e., running shoes for running).

Also, it is important to alternate shoes. Don’t wear the same pair every day.

A visit to your local podiatrist can be all you need to get your feet in shape for summer footwear, so schedule that now and be ready to show off your “fancy feet.”

Copyright © August 2009 American Podiatric Medical Association and Ankle & Foot Care Centers

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Follow These Tips for Ankle Sprains

Follow These Tips for Ankle SprainsSummer is also a great time to get outside and enjoy yourself. But an increased activity level can often lead to problems with our feet and ankles, particularly ankle sprains.

Local emergency rooms see increases in sprained ankles in the summer months. Most of us have twisted an ankle at some point, either while doing something as simple as stepping off a curb, or while enjoying a sport like basketball, tennis or running.

But sometimes these “twists” can be more serious and need to be treated by a podiatrist as quickly as possible. If your ankle becomes swollen, painful, or bruised after you injure it, you have most likely sprained your ankle. This means you have probably stretched and possibly torn the ligaments in your ankle. It’s important to take immediate action and to call your podiatrist to make arrangements for an evaluation.

First, if an injury or accident does occur, the steps you can take to help yourself until you can reach your podiatric physician are easy to remember if you can recall the word “RICE.”

• R = Rest. Restrict your activity, and get off your foot/ankle.

• I = Ice. Gently place a plastic bag of ice wrapped in a towel on the injured area in a 20-minute-on, 40-minute-off cycle.

• C = Compression. Lightly wrap an elastic bandage around the area, taking care not to pull it too tight.

• E = Elevation.

To reduce swelling and pain, sit in a position that allows you to elevate the foot/ankle higher than your heart. If the sprain is mild, the podiatrist may not take X-rays.

But with more severe sprains, you may need X-rays or advanced imaging studies. These studies can rule out broken bones, ligament or tissue damage, and cartilage damage in the foot and ankle.

In addition, these studies can determine if there are any growth plate injuries in children. To help your ankle heal, the podiatrist may suggest that you wear a protective brace or some form of ankle support. Occasionally, the doctor may immobilize the foot and ankle in a soft or hard cast so that the healing can occur more rapidly.

Rest is particularly important, so in order to keep your weight off the ankle, the podiatrist may also suggest that you use crutches for a defined period during healing. In addition, anti-inflammatory medications will probably be suggested to reduce swelling and pain.

After a specific period of time recommended by the podiatrist, you may be required to do some physical therapy, either at home or with a certified therapist. Since it is important to make sure that the ankle is fully healed before returning to sports and activities, the doctor may also recommend taping your ankle or wearing a supportive brace.

Copyright © August 2009 American Podiatric Medical Association and Ankle & Foot Care Centers

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Heed These Potential Signs of Skin Cancer in Feet

Summer is often the time we hear more about skin cancer. We’re told to avoid the sun if possible and always wear sunscreen when we are in the sun.

But many people never think about their feet when they take preventive action, even though malignant melanoma (a serious type of skin cancer) can affect the legs and feet as well as other parts of the body.

Heed These Potential Signs of Skin Cancer in FeetMelanomas on the feet can occur in men and women, and while they usually develop in people over the age of 50, they can be found at any age. Lighter-skinned people are more likely to develop melanomas on sun-exposed areas of the body, but only one-third of African-American patients who have melanoma develop it on sun-exposed areas.

In the African-American population, melanomas most often develop on skin that is not exposed to the sun, such as the foot and under the toenails. Early detection is extremely important since malignant melanoma can spread (metastasize) rapidly.

Since melanomas on the foot and ankle often go unnoticed during their earliest stage, routine foot examinations can increase the likelihood of diagnosing and treating malignant melanomas. During routine examinations your podiatrist will always look for moles, or “nevi,” which are usually evenly colored, round spots on the skin or even under the nails.

Most are small and don’t change in size or shape. However, the doctor will carefully examine any moles that look “abnormal.” The podiatrist will use a common dermatological rule (the “ABCD” rule) to characterize the melanoma:

• Asymmetrical lesions

• Border irregularity

• Color variation

• Diameter greater than the size of a pencil eraser.

Skin cancer is rarely painful, so routine podiatric medical visits are important for anyone with questionable lesions on the feet. Other signs to watch for are changes in color or a mole that becomes raised from the skin. Malignant melanomas on the feet usually occur between toes, in and around the nails, and on the soles of the feet.

Copyright © August 2009 American Podiatric Medical Association and Ankle & Foot Care Centers

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