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A newsletter from Ankle & Foot Care Centers.

July 2013 Edition:

Dr. DiDomenico Lectures at National Conference

Dr. DiDomenico Lectures at National ConferenceDr. Lawrence A. DiDomenico, managing partner of Ankle & Foot Care Centers, was invited to present a lecture at the Save A Leg, Save A Life (SALSAL) Foundation’s national conference in Lake Buena Vista, Fla.

Dr. DiDomenico, who sees patients out of Ankle & Foot Care Centers' Boardman, East Liverpool and Northside offices, along with his partner Dr. Gregory Blasko, is co-founder of the Youngstown SALSAL chapter.

SALSAL’s goal is to “reduce the number of lower extremity amputations and to improve the quality of life for our fellow citizens who are afflicted with wounds and complications of diabetes and peripheral arterial disease.”

“We are honored that one of our physicians had the opportunity to present at the SALSAL national conference,” said Michael Vallas, practice administrator. “SALSAL is doing important work and Dr. DiDomenico has been instrumental in bringing that message to the Mahoning Valley.”

Copyright © July 2013 Ankle & Foot Care Centers

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Ankle Fusion Procedure Restores Mobility for 80 Year-Old

Lois Sevy’s history of lower extremity health issues dates back to the 1960s when she first started having difficulty walking. It gradually worsened to the point of not being able to walk without a limp, and she ultimately underwent a bilateral hip replacement at age 50.

Ankle Fusion Procedure Restores Mobility for 80 Year-OldA list of complications arose during that procedure and subsequent surgeries – nerve damage, circulation problems, infections, swelling, other wounds – that created a 30-year medical history that made finding a specialist to treat new, emerging issues very difficult.

Lois simply wanted to be able to get around better, but an earlier procedure left a 1-inch deficiency in the length of one of her legs, and walking with a built-up shoe and cane proved to be cumbersome and painful. Her foot and ankle had become fragile, and walking this way caused pressure sores and a gradual breakdown of her skin.

Lois and her husband searched for a long time to find a surgeon willing to take on a difficult case, and it turned out he was two blocks away from their home the whole time.

The couple was steered by an acquaintance to Dr. Lawrence DiDomenico of Ankle & Foot Care Centers, who saw patients out of the practice’s East Liverpool office near the Sevys’ home. Dr. DiDomenico studied the case and carefully proceeded to order circulation studies. From there, he ascertained that a foot fixation procedure was reasonably safe and he agreed to take on what he referred to as “the challenge.”

Dr. DiDomenico’s foot fixation surgery involved removing the cartilage at the ankle joint, and compressing the ankle and leg bones with plates and screws so that the bones fuse.

“The surgery was done without incident and healed very well,” Lois said. “While I still walk with two canes, the other healing problems disappeared and my life returned to as normal as could be expected. We are so grateful to Dr. DiDomenico for getting me off the couch and back on my feet.”

Copyright © July 2013 Ankle & Foot Care Centers

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Dr. Groner Coaches Up Next Generation of Podiatrists

Meet the DocHe’s seen this scenario play out many times. A base runner rounds second and slides into third, jamming an ankle or suffering a wound injury in the process.

So, who is generally the first person coaches and parents look at to diagnose the situation? You guessed it – Dr. Thomas Groner.

In addition to serving as a coach for some of his children’s sports teams, he’s often tabbed as the unofficial team trainer in various injury situations. Whether it’s baseball, basketball or other sports, Dr. Groner has been involved in athletics in one form or another his whole life.

“I really like the sports medicine aspect of podiatry,” said Dr. Groner, who practices general podiatry with a subspecialty in wound care. “You see a wide variety of injuries in athletics.”

Dr. Groner practices in Ankle & Foot Care Centers’ Alliance office and spends a great deal of time at the practice’s wound center.

He also maintains a strong relationship with Alliance Community Hospital, where he works as the assistant clinical director of the residency program.

Dr. Groner Coaches Up Next Generation of PodiatristsWhen he’s not juggling a full schedule at Ankle & Foot, he teaches the next generation of podiatric physicians through the hospital’s residency program. He is one of three doctors who participate in the program, and the only podiatrist. He enjoys the opportunity to pass along his skills and knowledge.

“I really like teaching,” said Dr. Groner. “It’s rewarding to teach the residents some of the things that maybe they wouldn’t have learned until they get into practice. Things like how to bill or other clinical things that I can tell them to look out for.”

Dr. Groner, a graduate of Cardinal Mooney, attended Youngstown State University and the Ohio College of Podiatric Medicine in Cleveland. He completed his residency at Forum Health in Youngstown. He joined Ankle & Foot Care Centers in 2004.

“Ankle & Foot Care is still the best-known, state-of-the-art podiatry practice in this area,” said Dr. Groner. “We see a variety of things in our office and we’re always busy with some sort of procedure in the office or other wound care.”

He married another Mahoning Valley native, Leanne, and is the father of their four active children.

Copyright © July 2013 Ankle & Foot Care Centers

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Gingie Brock Celebrates 15 Years at Ankle & Foot

Employee SpotlightGingie Brock would be the first to tell you that she enjoys a good argument. That willingness to fight the good fight serves her well on the job in the billing department at Ankle & Foot Care Centers.

“It feels good when I’m right,” said Brock, who is part of the 11-member billing team in the East Liverpool office. “I like battling with the insurance companies and finding a way to get claims paid for our patients and our physicians.

“I really like the flexibility,” she explained. “I can’t really think of any times when they’ve told me I can’t be off if I needed to do something. I don’t have to work weekends, either, so that is great. There aren’t too many jobs these days where you can only work Monday through Friday.

“I was basically born and raised in East Liverpool. So only having a short ride to work is a good little perk of this job. That and the flexibility and vacation time are really nice.”

As an avid runner, Gingie knows full well the value of a fully healthy body. She generates a lot of satisfaction from knowing that she’s part of the Ankle & Foot Care team whose podiatric physicians make a difference in people’s lives and help them maintain active lifestyles.

Gingie Brock: Taking On Insurance Companies“You really don’t realize how much you rely on your feet until you get hurt,” said Gingie. “I had some problems with my heel, but they [Ankle & Foot Care] treated me and I feel good. It’s a great feeling working with doctors who impact peoples’ quality of life.”

Gingie’s role in the billing department includes submitting claims to insurance companies, data entry, posting payments, accounts receivable, and maintaining patient accounts. Since the department’s staff of 11 is charged with billing for services at all 18 locations, there is plenty to do.

“I have lots of duties,” said Gingie. “It’s pretty fast paced here, but we keep up as much as we can. We have a full schedule.”

After a stressful day debating with insurance companies, Gingie can be found relieving her stress through running, bicycling or hitting the gym.

Copyright © July 2013 Ankle & Foot Care Centers

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Foot Checks Lead to Early Detection of Skin Cancer

Next time you slip on your flip-flops before an afternoon in the sun, take a minute or two to check out your feet. That extra time could save your life.

While some people do a decent job of remembering to lather on the sunscreen to the face, neck, back and other skin areas commonly exposed to the sun, one critical spot is often overlooked – the feet. This can prove to be a costly oversight.

Surprisingly, one of the leading places skin cancer is commonly being found these days is on the feet. Often, the feet are the last place people think about when taking measures to prevent exposure to UV rays that are a leading cause of skin cancer. As a result, skin cancer on the feet can go undetected for far too long.

The most common areas of the feet to find skin cancer are the soles of feet, between the toes and around or under toenails. In the summer, when shoes are shed for open-toed footwear, the feet are often exposed to the sun for hours at a time. Melanoma can develop anywhere on the body, including these areas of the feet.

Who’s at risk?
Unlike many other types of cancer, melanoma strikes people of all age groups, even the young. Whites are 10 times more likely to develop melanoma than blacks. But studies suggest more than half of melanoma cases in blacks involve the foot, where late diagnosis leads to a higher death rate. Other risk considerations include:

  • If you’re in your 50s or older, make checking your feet a regular routine — because this is the prime time for melanoma to develop.
  • Men and women are equally at risk of getting skin cancer on their feet.
  • Other risk factors include being Caucasian, having light skin and blue eyes.

What can I do?
Routine foot exams at home or by a podiatric physician at Ankle & Foot Care Centers can increase the likelihood of noticing suspicious moles, freckles or other spots. According to statistics, half of the people who learn they have melanoma of the foot die within five years because the cancer had already spread throughout their body by the time it was diagnosed.

If a mole, freckle or spot starts to change over the course of a month and becomes asymmetrical or changes its border, color, diameter or elevation, see a physician immediately. Those are the ABCDEs, or signs, of melanoma.

Examine the soles of your feet, and be suspicious of any mole or freckle found there. According to dermatologists, moles and freckles are not commonly seen on the soles of the feet. If you spot one, it should be checked out immediately — because they tend to spread quickly, grow rapidly, and often result in death.

As you age, completing a thorough inspection of your feet can become more challenging, as flexibility starts to diminish making it harder to see all angles of your feet. Ways to overcome this obstacle include using mirrors or a large magnifying glass to focus on the hidden areas. If you can’t do it yourself, ask a spouse to help.

If you’d rather have more peace of mind about it, schedule a visit with a podiatric physician at Ankle & Foot Care Centers, who will check your feet for any potential concerns.

Copyright © July 2013 Ankle & Foot Care Centers

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The ‘Ouch’ Factor: What to Do About Splinters

The ‘Ouch’ Factor: What to Do About SplintersThe warm, sunny weather of summer is an invitation for us to shed our shoes and socks and run barefoot. However, running or walking (both inside and outside) barefoot places us at risk of splinters.

When you have a splinter in your foot, you will feel pain or discomfort and the sensation that something is embedded in the skin. Although wood splinters are most common, tiny bits of plastic, shards of metal or even broken glass can penetrate an unprotected foot.

While small splinters can be removed at home, any large or deep splinters in the foot should be removed by a podiatric physician. Anyone with diabetes should be especially vigilant, because a small splinter can grow quickly into a serious infection.

There are numerous home remedies that can help make removing splinters simple and fairly painless. Here are steps you can follow to safely remove a splinter from the foot:

  1. Start by soaking the foot in warm water to soften the skin.
  2. Wash your hands and gently clean the area of your foot in which the splinter is lodged.
  3. Once the skin is soft, try to squeeze out the splinter by putting your fingers on either side of the splinter and pinching gently.
  4. If the splinter won’t come out by squeezing, disinfect a pair of tweezers and a needle with rubbing alcohol, iodine, or boiling water and let them dry. If the splinter is still sticking out of the skin, use the tweezers to grasp the end and pull gently but firmly.
  5. You want to avoid breaking the splinter, which would leave the tail end in the skin. To remove the entire splinter, pull it out at the same angle that it entered the body. Most splinters will come out easily.
  6. If you can’t grasp the splinter with the tweezers, use the very tip of a sterile needle to slightly open the skin where the splinter is lodged. Grasp the end of the splinter with the tweezers and pull firmly. Do not dig for the splinter.
  7. Disclaimer: Use of a needle can assist with the removal of a splinter. However, use with caution to prevent further injury.
  8. Remember to gently wash your foot once you’re done.

Contact a podiatric physician if you’re having trouble reaching the splinter, if you are making the wound worse, or if the area becomes red, swollen, or hot to the touch, either after you remove the splinter or you cannot see any foreign body under the skin.

Whatever is embedded in your foot will determine how the podiatric physician will treat you. Deeply embedded foreign bodies may require a surgical procedure. Sometimes a local anesthetic is needed to completely remove a foreign body.

One good way to avoid splinters is to wear shoes both in the house and outside. There are many great options for summer besides bare feet, so keep feet healthy and happy by making good choices and avoiding splinters.

Copyright © July 2013 American Podiatric Medical Association and Ankle & Foot Care Centers

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From The Kitchen: Lemon-Thyme Chicken with Heirloom Tomato Salad

From The KitchenIngredients
4 boneless skinless chicken breasts, cut in half crosswise
1 lemon
4 tablespoons extra-virgin olive oil, plus more for frying
4 fresh thyme sprigs
2 garlic cloves, finely chopped
1 pound mixed heirloom tomatoes
2 tablespoons red wine vinegar
Kosher salt
Freshly ground black pepper
Fresh basil leaves

Put the chicken into a shallow dish. Grate the zest from the lemon over the chicken. Cut the lemon in half and squeeze over the juice. Add 3 tablespoons of the oil along with the thyme, and garlic. Mix everything together so the chicken is well coated with all the flavorings. Cover and let sit for 30 minutes, or refrigerate for up to 4 hours.

While the chicken is marinating, prepare the tomato salad: Cut the tomatoes into 1/2-inch pieces and put them into a bowl. Add the vinegar, and remaining 1 tablespoon olive oil. Season, to taste, with salt and pepper, tear in the basil leaves, and gently mix to combine.

When you are ready to cook, remove the chicken from the marinade, scrape off the herbs, and season with salt and pepper. Heat a large skillet over medium-high heat and put a thin coating of olive oil into it. Cook the chicken, working in batches if necessary, until it is golden brown and cooked through, about 3 to 4 minutes per side. Remove the chicken from the pan and let it rest for 5 minutes.

To serve, place 2 pieces of chicken onto a plate, and spoon 1/4 of the tomato salad over the chicken. Spoon on some of the tomato juices as well. Repeat with the remaining chicken and tomatoes and serve.

From The Kitchen: Lemon-Ginger Shortbread

Per serving: Calories 225; Total Fat 10 g; (Sat Fat 1.6 g, Mono Fat 6.5 g, Poly Fat 1.3 g) ; Protein 28g; Carb 5 g; Fiber 1.5 g; Cholesterol 68 mg; Sodium 83 mg

Copyright © 2013 Food Network Magazine

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