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A newsletter from Ankle & Foot Care Centers.

February 2012 Edition:

March Seminar on Ankle Arthritis and Gout

Ankle & Foot Care Centers is hosting a seminar covering two common podiatric conditions – ankle arthritis and gout – in Boardman on March 26 featuring local physicians Dr. Lawrence A. DiDomenico and Dr. David Regule.

Podiatric physician Dr. DiDomenico will address the warning signs, symptoms and the range of treatment options available for ankle arthritis sufferers, up to and including total ankle replacement.

There’s a national concern about the growing incidences of gout, most commonly diagnosed among men. Dr. Regule, a Boardman rheumatologist, will share information about the causes of gout, myths about the condition, and how to manage and treat it, if diagnosed.

The 90-minute seminar is free and open to the public. Pre-registration is required. Call 330.758.6226 x204 to register and receive further meeting details.

Copyright © February 2012 Ankle & Foot Care Centers

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Reconstruction Avoids Amputation, Restores Independence

Rob Stock’s life-changing series of events started in the summer of 2005 when, as a truck driver, he dismounted his rig at a truck stop directly onto a puddle of motor oil, which sent his foot one way and his body the other.

Requiring a two-week hospital stay some 900 miles away in Joplin, Mo., the accident shattered not only Rob’s ankle, but his vocation as a truck driver. His condition was further complicated by diabetes and a staph infection, and doctors in Ohio upon his return gave reconstructing Rob’s ankle a 20 percent chance at success; otherwise it would require amputation.

A local surgeon referred Rob to Dr. Lawrence A. DiDomenico of Ankle & Foot Care Center for a second opinion.

Rob Stock emphasized the need to follow the doctor’s instructions and participate in your own care to improve your chances at success.
Going into his appointment, Rob told himself he’d pursue the reconstructive surgery if the chance for success grew to 50 percent. To his surprise, Dr. DiDomenico gave surgery a 90 percent chance at saving his foot, “if you do what I tell you,” Rob remembered the doctor telling him.

Rob had read the morbidity rate for an amputee is five years post-surgery, and with a 9 year-old daughter and 18 year-old son, those odds were unacceptable to him. Facing a lifetime on disability, Rob’s priorities shifted to avoiding amputation and regaining his ability to walk and live independently.

The long road to recovery started in November of 2005 after Rob had successfully readied himself for surgery. The reconstruction was a 6.5 hour procedure involving the removal of the talus bone and subsequent repacking of the area with bone matter. Then a series of screws were put in place to stabilize the ankle, anchored by a long nail from the heel to the tibia to hold it in place. External fixation consisting of rods, wiring and framing further stabilized the reconstructed ankle.

Frequent staph infections and three times per week doctor’s appointments marked the first year of recovery, and in February 2007 a custom-made walking boot got Rob back on his feet, albeit temporarily. A setback occurred that required a second procedure; one that ultimately led to nearly five years of stabilization to keep the foot closed and the fusion together.

“It was a long road, but I just wanted to get my life back,” Rob said. “Dr. DiDomenico’s main goal was to restore my independence. I was in a wheelchair for so long, and all through the recovery I had to rely on other people to get where I needed to go. All I wanted was to be able to go to the grocery store, doctor’s office, visit my kids or walk around the house – on my own.”

During treatment and recovery Rob also learned to appreciate the patient’s role in the healing process.

“I look at it as it’s not just the doctor; you have to participate in your own care,” he said. “The doctor mentioned to me there are patients he has to amputate after they don’t listen to his instruction – and by then it’s too late.”

Rob, now 54, is down to one doctor visit a month, and he’s walking with the aid of a cane. He’s got 30 percent use of his foot, which won’t enable him to pass the commercial drivers license test, but his independence, lifted spirits and time with his children have dramatically improved his quality of life.

Copyright © February 2012 Ankle & Foot Care Centers

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Specialist Saves Foot, Restores Mobility After Bad Break

To say that Austintown resident Glenn Taylor, now 44, caught a bad break after a shopping visit to a local big-box retail store in 2007 is a gross understatement.

Upon leaving the store his right foot stepped awkwardly off a curb, setting off a series of events that would eventually lead to more than 20 foot and ankle surgeries over the next four years.

It was June of 2007 when the initial injury occurred. The foot swelled and Glenn went to the emergency room the next morning. Diagnosed with a sprained ankle that he was told would take six weeks to heal, Glenn felt something wasn’t right about four weeks in.

His primary care doctor referred him to an orthopedic surgeon who, after checking a new x-ray against the original one from the ER, couldn’t believe they were the same foot. He pointed out that there were two fractures and a dislocation that were not diagnosed nor treated on the original x-rays from the ER. The new diagnosis: Total collapse of the midfoot.

“He said my type of break was out of his hands,” Glenn recalled. “He said my foot had collapsed and if this were 10 years ago it would have been amputated. Thankfully he knew of a specialist.”

That specialist was Dr. Lawrence A. DiDomenico at Ankle & Foot Care Centers. The orthopedic surgeon had recently heard Dr. Domenico speak at a seminar and had his cell phone number saved in his phone. He called from the exam room and caught Dr. DiDomenico on a vacation. Glenn was able to schedule an appointment the doctor’s first day back in the office.

Glenn credits Dr. Lawrence A. DiDomenico and the staff at Ankle & Foot Care for their expertise and support during his complicated treatment process.
Dr. DiDomenico recommended surgery. He told Glenn he wanted to fuse his midfoot and use a halo device for support and immobilization post-operation. Being Glenn’s first surgical experience, he consulted with surgeons in Cleveland, Akron and Pittsburgh for alternate opinions. All three of them said they’d either consult with “a surgeon in Youngstown named Dr. DiDomenico” or refer me to see him directly. That was the assurance and confidence Glenn needed.

Glenn’s was a complicated case. Due to continuing degeneration, one procedure would lead to another. Infections came and were treated. Setbacks and complications, which are sometimes an unfortunate side effect of surgery, occurred. Through it all, however, Glenn credits the team of professionals at Ankle & Foot Care Centers for their expertise and support.

“The office staff has been nothing but professional. They’re genuinely concerned about my well-being,” he said. “Dr. DiDomenico is on top of the latest conventions and technology in his field. He’s one of the hardest working men I know. I’d recommend him to anyone.”

Knock on wood, Glenn is at the completion of his lengthy treatment and recovery. Over the past four years he’s been on crutches all but six months of it. He’s had to table the active lifestyle he’d grown accustomed to, including scuba diving, fishing, hunting, water skiing and snow skiing. And he’s changed careers to one that’s more befitting to a lack of mobility.

“People don’t realize how much they use their feet until they don’t have use of them for a while,” Glenn said in another understatement.

With a fused ankle taking an inch off his right leg, and the amount of hardware he’s had installed in his foot, Glenn will have to be extremely cautious with his foot the rest of his life. He may never be the athlete he once was, but he’s optimistically looking forward to slowly getting back to some of his more modestly active pastimes.

Copyright © February 2012 Ankle & Foot Care Centers

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Lifelong Valley Resident Dr. Emch Among Founders of Practice

Dr. Kenneth EmchDuring Dr. Kenneth Emch’s undergrad years at Youngstown State University he spent time with a couple of area podiatrists. Over time Dr. Emch got to know and appreciate the clinical and surgical components of the podiatry profession. And he got hooked.

Upon graduating from YSU he enrolled at the Ohio College of Podiatric Medicine in Cleveland. Four years later he was serving a surgical residency, including time as chief resident, at the Foot Clinic at the Youngstown Osteopathic Hospital.

Dr. Emch grew up in the Mahoning Valley on Youngstown’s North side, and had the opportunity to join a new, local podiatry practice that was forming as he completed his residency. In 1994 he joined up with Dr. Lawrence DiDomenico and Dr. Robert Debiec to form Ankle & Foot Care Centers, which today is a 19-office regional podiatry practice spanning Columbiana, Mahoning and Trumbull Counties, and Greenville, Pa.

Meet the DocDr. Emch, certified by the American Board of Podiatric Surgery and the American Academy of Wound Management, sees patients with a broad range of foot and ankle issues, and has particular clinical interests in sports medicine and wound care. In addition to his practice, he’s the section director of podiatry at St. Elizabeth Boardman.

When he’s not in the office you can often find Dr. Emch attending one of his children’s sporting events or school activities. His oldest son is a freshman at Cardinal Mooney High School interested in golf, and his daughters, 14 and 12, participate in everything from volleyball to basketball and cheerleading at St. Charles School in Boardman.

The Boardman resident also enjoys playing golf and following his favorite football teams, the Dallas Cowboys, Notre Dame and Ohio State.

Copyright © February 2012 Ankle & Foot Care Centers

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"Show-Biz Toes"— What Are They Really Worth?

If you read the tabloids or watch entertainment television, you may have learned recently that some movie stars are opting for cosmetic foot surgery. These stars of screen and stage are choosing to undergo surgery to correct unsightly problems that are not affecting their gait or comfort; they are having surgery just to look better. While some surgical procedures that are done to correct painful problems often have cosmetic implications, opting for foot surgery without pain first may not be a good choice to make.

According to the American Podiatric Medical Association (APMA), “surgical procedures of the foot and ankle are generally performed for relief of pain, restoration of function, and reconstruction of deformities. They may have the additional benefit of improved appearance. Surgical procedures performed for aesthetic purposes carry the same risks as those performed for medical reasons. Patients considering surgery of the foot or ankle, whether for medical or aesthetic reasons, are advised to consult a member of the APMA.”

Choosing to undergo any surgical procedure requires careful consideration. Podiatrists performing surgery for medical or aesthetic reasons should have appropriate training, experience, and credentials to perform surgery properly, manage post-operative care, and treat possible complications.

Copyright © February 2012 American Podiatric Medical Association and Ankle & Foot Care Centers

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From The Kitchen: Italian Wedding Soup

From The Kitchen4 servings

1 tablespoon extra-virgin olive oil
1 small onion, finely chopped
3 carrots, finely chopped
2 cloves garlic, finely chopped
2 teaspoons Worcestershire sauce
2 teaspoons chopped fresh sage
3 cups fat-free low-sodium chicken broth
1 parmesan cheese rind, plus 1 tablespoon grated parmesan, plus more for topping
1/2 pound ground pork
3 tablespoons breadcrumbs (preferably panko)
3/4 cup orzo
8 ounces baby spinach (about 8 cups)

Preparation time: 30 minutes
Total time: 40 minutes

  1. Heat the olive oil in a large pot over medium-high heat. Add the onions and carrots and cook, stirring, until slightly softened, about 4 minutes. Add half of the garlic and 1 teaspoon each Worcestershire sauce and sage; cook 1 minute. Add the chicken broth, 3 cups water and the parmesan rind and bring to a boil. Cover, reduce the heat to medium and simmer until the vegetables are tender, about 7 minutes.
  2. Meanwhile, mix the pork, breadcrumbs, 1 tablespoon grated parmesan, the remaining garlic and the remaining Worcestershire sauce and sage in a bowl. Form into 1-inch meatballs.
  3. Increase the heat to medium high and bring the soup to a boil. Stir in the orzo and cook 6 minutes. Add the meatballs and cook until they are firm and float to the top, about 4 more minutes. Stir in the spinach and cook until wilted, about 1 more minute. Ladle the soup into bowls and top with parmesan.

Per serving: Calories, 350; Fat 18 g (Saturated 6 g); Cholesterol 62 mg; Sodium 304 mg; Carbohydrate 29 g; Fiber 5 g; Protein 19 g

Copyright © 2012 Food Network Magazine

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