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A newsletter from Ankle & Foot Care Centers.

March 2013 Edition:

Dr. DiDomenico Lectures at Foot & Ankle Surgery Conference

Dr. Lawrence A. DiDomenico, managing partner of Ankle & Foot Care Centers, presented five lectures at the recently concluded Annual Scientific Conference of the American College of Foot and Ankle Surgeons organization in Las Vegas.

Dr. DiDomenico Lectures at Foot & Ankle Surgery ConferenceDr. DiDomenico, who practices out of Ankle & Foot Care Centers’ Boardman, East Liverpool and Northside offices, also presented seven posters at the conference attended by 1,400 foot and ankle surgeons, most of which discussed getting foot and ankle surgery patients up and moving quicker with early weight bearing following surgical procedures.

Topics for his lectures included bone grafting, tendon transfers, charcot joint reconstruction, an update on fixation and surgical correction of bunionectomies.

Poster presentation topics included “Immediate Weight Bearing Following Bunionectomy;” “Pediatric Flatfoot Surgery Repair of An Iatrogenic Plantar Lateral Nerve Laceration;” “Retrospective Measurements of Sesmoid Position for the Lapidus Bunionectomy Without Performing a Lateral Release;” “Frontal Plane Rotation of the Sesmoid Apparatus During the Lapidus Procedure;” “Resolution of Idiopathic Dropfoot Following Nerve Decompression;” and “Early Weight Bearing with Utilization of Locking Plate Technology for Fifth Metatarsal Osteotomies.”


Copyright © March 2013 Ankle & Foot Care Centers

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Diabetic Patient Gets the Best Result in a Worst Case Scenario

Ryan Kyle has struggled with diabetes and his weight for a long time.

When he was thirty years old his toes began to curl backwards and the tips of his toes started to break open. He wound up getting an infection.

Two years later the infection spread to the other foot. Ryan felt he wasn’t getting the care he should’ve been getting from his current physician. That’s when a friend told him some good things about Dr. Lawrence A. DiDomenico.

Dr. DiDomenico found that Ryan’s toes were pretty badly infected and wound up having to amputate two of his toes.

But that wasn’t the end; Ryan developed an ulcer on his left foot.

At the time, he owned a small horse farm and couldn’t stay off his feet. That, along with the diabetes, meant the problem kept getting worse and worse leading to several very serious infections.

Dr. DiDomenico told Ryan there was a 50/50 chance he was going to lose his foot and lower leg. “His knowledge and education is so vast it’s almost like he can look into a crystal ball and let you know what will happen. He has a very straightforward, honest approach. He wants you to understand the reality of the situation. He has empathy but on the other hand he isn’t going to sugar coat something.”

Dr. DiDomenico prescribed antibiotics, had Ryan use a vacuum wound pump, sent him to the hospital for highly pressurized oxygen treatments, and performed numerous surgeries. In doing so, Ryan’s right foot was completely healed. “I’ve gone a good six years without even so much as a blister on that foot.”

But, on the left foot, Dr. DiDomenico found the infection had gotten into the bone and wound up having to perform a trans-metatarsal amputation. This left Ryan with a foot that looks a lot like a ball.

“I was upset because of everything we’ve been thru and I still lost half the foot. But the cards were stacked against me with the bad foot structure and the diabetes. So, instead of looking at it like I lost my foot I looked at it like I retained my leg. I can lead a very functional life.”

Ankle & Foot Care Centers helped get Ryan a custom made boot and insert.

“My foot is ugly but healthy. I’m able to go the zoo with my wife and children. I’m able to walk into my son’s athletic events now. I’m doing so on my own two legs.”

Ryan has now been Dr. DiDomenico’s patient for about 11 years, and says he knows exactly what would’ve happened if he had never found him.

“If I had stayed with the original doctor there is no doubt in my mind that at the very least I would’ve lost my left leg and there would be a very real chance that I would be a double amputee.”


Copyright © March 2013 Ankle & Foot Care Centers

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Dr. Daniels Runs for a Cause

Dr. Mike Daniels took up the sport of running last year and his accomplishments to-date have been no small feat. Not only was his first race the high-profile Walt Disney World half-marathon, but his participation in the race helped raise more than $12,000 for childhood cancer research.

Dr. Daniels practices out of Ankle & Foot Care Centers’ Champion and Warren offices, and participates in the practice’s nursing home outreach program.

Meet the DocAt the 2012 Disney race, Dr. Daniels and his friend, Kevin Kuczmarski, ran to raise money for St. Jude’s Hospital. Kevin’s nephew, Trace, was diagnosed with brain cancer in February 2012 and is reportedly doing well now. Dr. Daniels had registered as a “St. Jude’s Hero” to support the organization’s lifesaving mission of finding cures and saving children.

This coming August Dr. Daniels aspires to race both in the half-marathon and 10k events on back-to-back days, this time at Disney Land in Anaheim, Calif.

Dr. Daniels’ affinity for running combined with word-of-mouth referrals have led to him treating more athletes as part of his foot and ankle practice. For runners specifically, he’s a firm believer that individuals with flat feet should wear custom orthotics in their running shoes for added arch support.

So how do you know if you have flat feet? Dr. Daniels said there are different degrees of flat feet, and a simple self-test can help you determine where you stand. From a standing position, reach down and place your fingers under your arch. If you can’t get any fingers under the arch you likely have flat feet.

“Custom orthotics help protect the posterior tibial tendon, cut down on strain and balance the foot,” Dr. Daniels said. “They ease the stress on other parts of the leg and overall help reduce injuries.”

Dr. Daniels further points out that Ankle & Foot Care Centers casts for custom orthotics right in the office, and oftentimes they’re covered by health insurance plans.

Dr. Daniels, who lives in Streetsboro, welcomed a third mixed-breed rescue dog to his home this past year. Chip, a dachshund-beagle mix puppy came from a shelter in Struthers.

Dr. Daniels Runs for a Cause
Dr. Daniels raised money for St. Jude Hospital while participating in a half-marathon at Walt Disney World in 2012.


Copyright © March 2013 Ankle & Foot Care Centers

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Kate McFarland: At Home When on the Road

When Kate McFarland first had the opportunity to assist on nursing home visits as part of Ankle & Foot Care Centers’ outreach program back in late 1999, she knew she’d found her niche.

“A friend of mine told me about an opening here 15-and-a-half years ago when I was looking to get into something more medical,” she recalled. “I started out as a filing clerk, and that turned into front office work. But I’m a people person, and when I got a chance to go on the road and help with the nursing home part of the practice it was more my cup of tea.

“Sometimes you’re the only person the nursing home residents see all day, and if I could help make them smile it really warmed my heart. Both the staff and the doctors always treated these patients with compassion and dignity, and I just loved that.”

Employee SpotlightAnkle & Foot Care Centers’ outreach program sees homebound patients in Trumbull, Mahoning, Columbiana and Mercer Counties, as well as residents in various Mahoning Valley nursing homes and apartment buildings. Most are initial consultations, follow-up care after office procedures, wound care, diabetic care (including diabetic shoe services) and routine nail care/lower extremity exams.

Before recently transitioning back to a full-time office position where she helps schedule the doctors and patients in the program, Kate’s role on the road was to prep nursing home residents for their appointments and get their paperwork in order.

“I would still do it if my body allowed,” she said of the role she performed for nearly 12 years.

Kate is a lifelong resident of the city of Youngstown and currently calls the West Side home. She’s a proud graduate of The Rayen School “when it was one of the top high schools in the state,” she said.

When she’s not working, you’ll likely find Kate at a family gathering with any number of her three grandchildren, two step-grandchildren or four great-grandchildren, or else at Mountaineer feeding the slot machines.

“I truly enjoy everything about working at Ankle & Foot Care,” she said. “The doctors are all great; they’ve all been a pleasure to work for and they’re all so progressive. They’re always looking at the newest advances for treating patients. And the practice is so well-known.”


Copyright © March 2013 Ankle & Foot Care Centers

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Running Shoes: Basic Guidelines

Running Shoes: Basic GuidelinesPeople run for many different reasons. For some, it gives them a positive energy boost, and it’s an ideal way to keep their weight in check. For others, it’s the buzz of competition, or quite simply, because they enjoy it.

One of the first steps to healthy running is wearing supportive running shoes. Neglecting to wear proper footwear can lead to a variety of foot problems that can cause injury and impede performance.

To find the best running shoe, you must first determine your foot type. Are you a pronator or a supinator, or do you have neutral feet? Pronators have relatively flat feet, leading to overpronation (gait in which the ankle rolls inward excessively). Supinators have high arches, leading to underpronation (gait in which too much weight is placed on the outside of the feet). And finally, if you have neutral feet, you have a foot that is in-between a flat-foot and high arch.

For assistance in determining your foot type, consult a podiatric physician. Your podiatrist will perform a gait analysis and provide suggestions about the best running shoe for your foot type. Taking the “wet test” is another way to determine your foot type. To take this simple test, wet the bottom of each of foot and stand normally on a paper bag. After a minute, step off and observe the imprint left by your foot.

Running Shoes: Basic Guidelines

Follow these basic guidelines for successful running shoe shopping:

  • Have your feet measured while you’re standing
  • Always try on both shoes and test your running shoes while still in the store
  • Shop for shoes later in the day; feet tend to swell during the day
  • Buy shoes that don’t pinch your toes, either at the tips, or across the toe box
  • Wear or buy the socks you’ll wear when you run
  • If you wear orthotics, bring them. You need to see how the shoe fits with the orthotic inside.
  • People who are pronators (low/flat arch) should choose a supportive shoe designed for stability and motion control. These shoes help to correct for overpronation.
  • People who have a neutral arch should choose a shoe with equal amounts of stability and cushioning to help absorb shock
  • People who are supinators (high arch) should choose a cushioned running shoe with a softer midsole and more flexibility. These features will compensate for the poor shock absorption of a high-arched foot.

If you suffer from bunions, finding the right running shoe may be a little tricky, but it can be done. Look for shoes that provide soft mesh at the sides for more comfort and cushioning, a wide toe box, and a snug heel for stability.

Looking for a pair of running shoes that fit your feet? View a complete list of shoes and products with APMA’s Seal of Acceptance. Go to and click on Learn About Feet.


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

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From The Kitchen: A Lighter Chicken Piccata

From The KitchenYield: Serves 4

1 pound chicken scaloppini (about 4 ounces each)
Kosher salt and freshly ground black pepper
1 tablespoon plus 1 teaspoon all-purpose flour, divided
3 teaspoons extra-virgin olive oil
2 garlic cloves, finely chopped
1/2 cup low-sodium chicken broth
Finely grated zest and juice of 1 lemon, zest reserved for optional garnish, about 2 tablespoons juice
1 teaspoon white wine vinegar
2 tablespoons chopped fresh parsley, plus more for garnish
1 tablespoon capers, drained and rinsed
1 tablespoon unsalted butter
Baby arugula for garnish
Whole-wheat angel hair pasta or roasted potatoes, for serving

Season the chicken with salt and pepper and sprinkle with 1 tablespoon flour.

Heat 2 teaspoons oil in a large nonstick skillet over medium-high heat until very hot; cook the cutlets until opaque throughout, 1 to 2 minutes per side. Transfer the cutlets to a plate. (Reserve the skillet.) Reduce the heat under the skillet to medium.

Add the remaining teaspoon oil and garlic to the same skillet; cook until fragrant, about 1 minute. Whisk together the broth, lemon juice and 1 teaspoon flour, and add to the pan. Simmer sauce until reduced and thickened, 2 to 3 minutes. Stir in the vinegar, parsley and capers. Swirl in the butter until sauce is shiny and slightly thickened.

Serve chicken with the sauce. Toss the arugula and freshly grated lemon zest with a light drizzle of olive oil; season to taste with salt and pepper, scatter over chicken. Serve with pasta or potatoes as desired.

Total time: 37 minutes (prep: 25 minutes, cook: 12 minutes)

From The Kitchen: A Lighter Chicken Piccata

Per serving (does not include the arugula or pasta/potatoes): Calories: 207; Total Fat: 9.5 grams; Saturated Fat: 3 grams; Protein: 25 grams; Total carbohydrates: 4 grams; Sugar: 0 grams; Fiber: 0 grams; Cholesterol: 73 milligrams; Sodium: 268 milligrams


Copyright © 2013 Food Network Magazine

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