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A newsletter from Ankle & Foot Care Centers.

December 2011 Edition:

Orthopedic Surgeon from Germany Chooses
Ankle & Foot Care Centers for Prestigious Fellowship

German orthopedic surgeon Dr. Thomas Muckley applied for and won a prominent European fellowship to study Charcot syndrome among diabetes patients. The Board of Directors of the German Association of Foot and Ankle Surgery recommended he study with Dr. Lawrence A. DiDomenico of Ankle & Foot Care Centers, who’s earned a global reputation among podiatric surgeons for his unique experience with diabetes patients and frequent invitations to speak at European medical conferences.

Dr. Thomas Muckley, left, spent two weeks with Dr. Lawrence A. DiDomenico, right, as part of a fellowship he won from the German Association of Foot and Ankle Surgery.
“Diabetes is becoming larger in Germany, but it’s not yet to the level of the U.S.,” Dr. Muckley said. “Doctors in small hospitals in Germany don’t have the experience with Charcot and diabetes you have here. Due to his expertise and reputation there’s a heavy concentration of diabetes patients in Dr. DiDomenico’s office. Patients are referred here from all over the region, not just Youngstown, and being recommended by another patient or physician is the best reward you can get as a doctor.”The cultural exchange proved to be a two-way learning experience for Dr. DiDomenico.

“Dr. Muckley is a wonderful person and well-accomplished physician and medical researcher in his own right,” Dr. DiDomenico said. “He gave a couple of well-received lectures for residents here on traumatology and foot surgery, and he taught us a lot about the German healthcare system.

“We’re not a major university or a large metro area; we’re Youngstown. It was an honor to have an esteemed, published physician like Dr. Muckley leave his family for two weeks and spend time with us.”

Dr. Muckley left Youngstown impressed with the variety and sophistication of treatment options for diabetes patients, saying it was a big advantage for people living here to have access to such a high level of care.

“I’ve never seen a situation like this where you can have so much done in one office; diagnosis, treatment, surgery, and even MRI procedures and interpretation,” Muckley said. “In Germany we’re 10 years away from this level of specialization.”

Copyright © December 2011 Ankle & Foot Care Centers

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Dr. DiDomenico Addresses International
Foot and Ankle Surgical Conference in Spain

Dr. Lawrence A. DiDomenico, managing partner at Ankle & Foot Care Centers, was among a panel of lecturers who recently addressed an international orthopedic and podiatric surgical conference in Madrid, Spain.

Dr. DiDomenico’s lecture and workshop topics at the International Course of Theory and Practice of Foot and Ankle Surgery included ankle replacement, reconstruction of flat feet in adults, tendon transfers, and new trends in foot and ankle surgery.

The November event attracted orthopedic and podiatric surgeons, and medical specialists from throughout Europe.

Dr. DiDomenico is an accomplished foot and ankle surgeon who practices out of the East Liverpool, Boardman and Youngstown offices.

Copyright © December 2011 Ankle & Foot Care Centers

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Help Us Reach our Shoe Drive Goal: 800 Pairs of Shoes

Podiatric physicians and surgeons with Ankle & Foot Care Centers are urging holiday shoppers to help the area’s less fortunate by buying and donating new pairs of shoes.

The doctors aim to collect more than 800 pairs of shoes through January 6. Shoe collection stations are now in place at each of the group’s 19 Mahoning Valley locations, all of which are accepting new or nearly new shoes. In greatest demand are children’s shoes of all types and casual, all-purpose shoes in adult sizes for both men and women.

Since 1998, Ankle & Foot Care Centers has helped local shoppers donate thousands of pairs of shoes to local needy families. Ankle & Foot Care Centers works with the Salvation Army, who in February will distribute the shoes collected this year to individuals throughout Mahoning and Trumbull counties.

Copyright © December 2011 Ankle & Foot Care Centers

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Vindy Spotlights Dr. Blasko’s Work With Elite Runner

A recent Vindicator feature story on elite runner Sarah Flament quoted her as crediting her podiatric physician, Dr. Greg Blasko of Ankle & Foot Care Centers, in her recovery from foot injuries.

“He has helped me tremendously,” Flament said in the article, published Monday, Dec. 12. “I’ve made a lot of progress considering the time lost because of injuries…” (Read the full article here.)

Flament is training for the U.S. Olympic Trials next month in Houston. In a recent Ankle & Foot Update story, Flament talked about her successful treatment with Dr. Blasko for a stress reaction and plantar fasciitis.

Copyright © December 2011 Ankle & Foot Care Centers

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From Local Sandlots to Super Bowl, Family Time Drives Dr. Chiaro

It started out as a flippant comment by a 12 year-old Steelers fan during an exciting NFL playoff run in 2010.

“Hey dad, if the Steelers make it let’s go to the Super Bowl,” Tony Chiaro said.

Yeah, right. We’ll just drop everything and go, thought his father, Dr. John R. Chiaro, Jr., DPM, a podiatric surgeon at Ankle & Foot Care Centers.

After looking into what it would take to go, getting caught up in the excitement and scouring accommodation and ticket deals online, the Poland native turned the half-cocked idea into the ultimate father-son road trip.

“Going to the Super Bowl and spending that time with my son was an experience of a lifetime,” Dr. Chiaro said.

Meet the DocQuality family time with his wife and children is what drives Dr. Chiaro. He and his wife, Gina, a kindergarten teacher at Poland Union Elementary School, are regularly seen around the Mahoning Valley at their children’s year-round sporting events. Tony, now 13, is active in football, basketball and baseball, while daughter Marissa, 15, is a high school cheerleader.

Enjoying a family trip to New York City over Thanksgiving are Dr. Chiaro (back) and, left to right, son Tony, daughter Marissa and wife Gina.
Dr. Chiaro is also an avid golfer who sports a 13-handicap. He satisfies his competitive impulses by hitting the area’s golf courses a couple days a week with a group of friends, naming Oak Tree Country Club among his favorites.Staying active is not just an evening and weekend endeavor for Dr. Chiaro. He maintains a busy podiatric practice, specializing in wound care and limb salvage, particularly among those with diabetes.

“Working with a patient with a bad infection who’s been told he or she was going to lose a leg, and developing a treatment plan that enables us to save that limb is what gives me the most satisfaction professionally,” Dr. Chiaro says.

Dr. Chiaro has been practicing podiatry for 17 years, including the last 11 at Ankle & Foot Care Centers. He graduated from Youngstown State University and the Ohio College of Podiatric Medicine in Cleveland, and sees patients in the Poland, Alliance and Warren offices.

Copyright © December 2011 Ankle & Foot Care Centers

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After Surgery, Athlete’s Leg Holds Up ‘Like a Tank’

When Caleb Markusic twisted his left ankle and tore his deltoid ligament while playing indoor soccer, he figured his days as an athlete were over.

But thanks to a timely surgery by Dr. Greg Blasko of Ankle & Foot Care Centers, Caleb has played soccer, run track and completed military missions in Iraq and Afghanistan on the strength of his repaired leg.

Caleb Markusic, originally of Poland, Ohio, was treated for a severe ankle and leg injury during high school and went on to serve military missions in Iraq and Afghanistan.
“There’s a plate and seven screws in there, and that leg’s like a tank,” said Caleb, 23, a Poland High School graduate who served four years in the United States Marines Corps.

Caleb was a junior in high school in early 2005 when he sustained his injury. He was playing indoor soccer and twisted his left leg severely, tearing the deltoid ligament that connects the tibia to parts of the foot.

He felt it – and heard it. “It sounded like somebody broke a piece of wood,” he recalled. “It swelled up really big and went numb.”

The foot surgery involved using a plate and seven screws to stabilize Caleb’s ankle.

He wound up missing two weeks of school. When he returned, he wore crutches. As he worked through physical therapy, he wasn’t sure how active his leg would allow him to be.

“I was a little bit nervous about doing anything,” he said. “I had to ease into it. But I found out after a while that my leg was pretty much like brand new.”

Less than a year after his injury, he resumed playing soccer. Then he ran the 400 meters and
4 x 4 relay events on Poland High’s track team in his senior year. In the fall after his graduation, he joined the Marines, where he would serve four years, including seven-month tours in Afghanistan and Iraq.

In Iraq, he served in the infantry and was part of a four-man scout team that combed villages and rural areas, searching automobiles and houses. In Afghanistan, he served on patrols and fired missiles.

“There were a lot of 20-mile hikes, and my leg never bothered me too much,” Caleb said. “I’ve lost a little mobility, and it feels like I had surgery. But there’s been nothing disabling.”

After his military service, Caleb moved to Winston-Salem, N.C., where he now attends Forsyth Technical Community College.

Copyright © December 2011 Ankle & Foot Care Centers

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Surgery Saves Foot; 81 Year-Old Regains Mobility

Gene Manzo’s breakfast-to-remember three years ago had nothing to do with the coffee he enjoyed with his buddies that morning, but rather because it was the day he lost his mobility and independence.

After a misstep on a slanted curb as he left the restaurant, the then 78-year-old Parkersburg, 
W. Va., resident, who’d been dealing with diabetes and a fused left ankle causing bone-on-bone discomfort, badly twisted his already compromised foot.

Gene Manzo, of Parkersburg, W. Va., traveled to Boardman countless times over two years for treatment of his Charcot deformity.
“I was having ankle problems before that, but I could deal with it,” Gene said. By ‘deal with it,’ Gene meant he could still get around, manage the pain and live his life the way he wanted.

But after the incident with the curb, Gene’s health issues led him on a course that included two doctors, two failed surgeries, scary complications, years of immobility, and the inability to drive a car or – worse yet – a golf ball. Now relegated to a wheelchair, golf was the furthest pastime consideration for Gene. He thought he was going to lose his foot.

Diabetes affects the whole body, but it can take a particular toll on the feet and ankles, including causing nerve disease. For Gene, it ultimately led to Charcot deformity, a specific pattern of bone and joint damage.

Enter Dr. Lawrence A. DiDomenico of Ankle & Foot Care Centers. After hearing him speak at a conference about this particular type of foot problem, Gene’s physician in West Virginia contacted Dr. DiDomenico for an appointment for Gene. Encouraged, Gene made the trip to Youngstown with help from his daughters – countless times over the next two years – for treatment, surgery and follow-up care.

Now 81, Gene has recovered from a surgery that included a halo stabilization device and more than a dozen pins and screws, and he’s been dismissed from Dr. DiDomenico’s care. He’s graduated to walking with the help of a cane and he’s back to driving his four-wheel-drive Jeep again. And Gene still has his foot.

As for golf?

“I haven’t played golf in three years, but I hope to play nine holes next spring,” he said optimistically.

Copyright © December 2011 Ankle & Foot Care Centers

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You’ve Got To Move It, Move It–Especially When Traveling

Are you planning to travel this winter? If you’ll be spending long periods of time sitting still (either in your car or on an airplane) you may want to take heed of deep vein thrombosis (DVT). What is DVT? It can be painful and dangerous if you don’t know what it is and how to identify it while you’re travelling.

DVT can affect anyone but is most prevalent in adults over 60 years of age. DVT mainly affects the larger veins in the lower legs and thighs. A blood clot can develop and block blood flow, causing pain and swelling. A blood clot that breaks free and moves through the bloodstream is called an embolism. An embolism can lodge in the brain, heart, or lungs and cause severe damage.

The risk factors for DVT and blood clots include:

  • long periods of bed rest;
  • cigarette smoking;
  • fractures in the pelvis or legs;
  • giving birth within the last 6 months;
  • heart failure;
  • medications such as estrogen and birth control pills;
  • obesity; and
  • recent surgery.

There are ways to avoid DVT if you happen to have any of these risk factors. First and foremost, moving your legs often during long plane trips, car trips, and other situations in which you are sitting or lying down for long periods of time can help prevent DVT. You can do ankle circles, knee bends, and thigh lifts right in your seat. It’s also important to get up and move during plane travel. If you are travelling by car, stop periodically and walk for a few minutes. By moving around, you decrease your risk of DVT significantly.

Clinical evidence suggests that wearing compression socks or tights while travelling reduces the incidence of DVT on long flights, especially if you have any of the risk factors identified above. These products help improve circulation, which can be particularly important to decrease the risk of DVT.

Copyright © December 2011 American Podiatric Medical Association and Ankle & Foot Care Centers

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We’ve Gone Social; Follow Us on Facebook and Twitter

See what’s afoot at Ankle & Foot Care Centers through our newest social media initiatives, Facebook and Twitter.

You’ll learn about trends and advancements in foot and ankle health, news about Ankle & Foot Care Centers, events, special promotions and much more. Like us on Facebook and follow us on Twitter.

“These social media tools provide a convenient, modern method for communicating with our patients and their families,” said Michael Vallas, practice administrator at Ankle & Foot Care Centers. “They also provide a forum to interact with us through commenting and sharing ideas.”

Click on the icons below to be directed to our pages and start following us today.

Copyright © December 2011 Ankle & Foot Care Centers

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From The Kitchen: Herb-Roasted Turkey

From The Kitchen12 servings (3 oz.)

5 tsp. unsalted butter, softened
3 tsp. fresh minced sage (divided use)
3 tsp. fresh minced thyme (divided use)
3 tsp. fresh minced rosemary (divided use)
Kosher salt and freshly ground black pepper to taste
1.5 cups low-fat, reduced-sodium chicken broth
1 cup dry white wine
1 (5-lb.) turkey breast, skin on, washed and patted dry

Preparation time: 25 minutes
Cooking time: 1 hour, 20 minutes to 1 hour, 40 minutes

  1. Preheat oven to 350°F. Line a large roasting pan with foil. Set a rack inside roasting pan and coat it with cooking spray. Set aside.
  2. In a small bowl, combine the butter with 2 tsp. of each of the sage, thyme and rosemary, plus salt and pepper. Reserve the remaining 1 tsp. of each of the herbs.
  3. In a small saucepan, combine the chicken and wine, and bring to a gentle boil. Add the reserved herbs and bring to a simmer.
  4. With your hands, separate the turkey breast skin from the breast meat, creating a pocket without removing the skin. Rub the butter herb mixture all over the breast meat. Place the skin back down on the breast.
  5. Set the turkey on the prepared rack in the pan. (You can also add peeled veggies like peeled carrots, peeled parsnips, onions or small potatoes to the pan; they will cook along with the turkey.) Roast the turkey for about 1 hour, 20 minutes to 1 hour, 40 minutes until the internal temperature reaches 170°F and the juices run clear. Baste every 15-20 minutes with the mixture of chicken broth and white wine.
  6. Remove the turkey from the oven, cover loosely with foil, and let stand for 15 minutes before slicing. Discard the skin and serve.

Copyright © 2011 American Diabetes Association

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