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A newsletter from Ankle & Foot Care Centers.

September 2012 Edition:

Diabetes Golf Outing a Huge Success

Our 14th annual American Diabetes Association Golf Benefit in August was once again well-received by the community, and by raising more than $13,000 this year we pushed our cumulative total of dollars raised through the years to more than $100,000.

The event at Pine Lakes Golf Club was organized by Dr. Michelle Anania, and we’ve been sponsoring it since it began in 1999.

The tournament raises money for diabetes research, through Ankle & Foot Care Centers and the Tri-County Chapter of the American Diabetes Association.

Diabetes is a devastating disease that affects the lives of millions of Americans. The ADA's goal is to prevent and cure diabetes and to improve the lives of all people affected by the disease.

Ankle & Foot Care Centers has been a strong supporter of the ADA's Tri-County Chapter for many years, providing financial support while organizing support groups for diabetes patients and their families and helping to raise awareness of diabetes, especially as it affects the feet.

It’s never too early to start planning for next year. If you would like to play or if you know of a business that would like to participate as a sponsor, please contact Mike Vallas, Ankle & Foot Care Centers practice administrator, at

Diabetes Golf Outing a Huge Success

(L to R) Bill Lynch, Ralph Blanco, Vince Pecchia and Mike Senchak were among the players in our 14th annual golf outing to benefit ADA. Click here to see more photos of golf outing participants on our Facebook page.

Copyright © September 2012 Ankle & Foot Care Centers

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Walk for Diabetes set for Oct. 21 in Canfield

We’re proud to once again sponsor the Youngstown Step Out: Walk to Stop Diabetes in Canfield on Oct. 21. The walk includes a 2 or 3.5 mile route throughout the streets of beautiful downtown Canfield and the Fairgrounds.

Walk for Diabetes set for Oct. 21 in CanfieldMark your calendars for Sunday, Oct. 21 at the Canfield Fairgrounds. Registration begins at 9 a.m., and the walk starts at 10:15 a.m. Register today.

You can Step Out and make a difference! Everyone has a very personal reason for participating in Step Out: Walk to Stop Diabetes. What is yours?

Participants are changing the future and making a positive impact in the lives of those who are affected by diabetes. By registering, you will be helping the Association provide community-based education programs, protect the rights of people with diabetes and fund critical research for a cure.

Once you register, you'll be given your very own Step Out Center webpage to help you fundraise, and you will have access to lots of tools. From your Step Out Center, you can customize the page with your reason for walking, send emails to ask others to join you or donate, and even download Facebook and smart phone apps.

Copyright © September 2012 Ankle & Foot Care Centers

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Bunion Surgery Restores Comfort, Mobility for Kindergarten Teacher

While many in the teaching profession cherish the summer months as a mental respite from the demands of the profession, Hilda Freudenberg welcomed the three-month classroom break for physical reasons.

Hilda, 55, and a kindergarten teacher in the Youngstown city schools, suffered from painful bunions. For nearly a year she tried to treat it with orthotics. They helped manage the pain for a time, but ultimately she started experiencing a numbness in her feet. Then she knew surgery had to be done.

A bunion is an abnormal, bony bump that forms on the joint at the base of your big toe.

“All summer long I walk around barefoot or in flip-flops, but the pressure would really get me when I went back to professional shoes when school started back up,” she said. “And I’m a high-energy, active teacher, so I need to maintain my mobility to be able to teach the way I’m most effective.”

Hilda was referred to Dr. Robert Debiec at the Boardman (Rt. 224) office of Ankle & Foot Care Centers. At first, she resisted surgery because of the length of recovery time and the post-operative pain she’d heard about from friends.

Dr. Robert Debiec“Dr. Debiec told me a nine-week recovery period was typical, but mine was more like five weeks before I was up and walking. Plus, I didn’t experience the kind of pain some of my friends told me about,” she said. “My pain was about what one would expect with surgery, and I did everything Dr. Debiec told me to do during recovery.”

Hilda had surgery during her school’s spring break, and was able to return to work in a limited capacity in time for the end-of-the-year tests and activities.

“I can’t say enough about Dr. Debiec,” she said. “He has such a great attitude and demeanor. I tell everyone who did my surgery, and I would definitely go back to Dr. Debiec.”

Before surgery, Hilda wore an extra-wide shoe on her affected foot for comfort, and the pain would shoot across the bottom of her toes and bother her at night after a long day. Post-surgery and therapy, her left foot is noticeably narrower and free of pain. Now she’s planning to have her right foot done next year.

“I want to go ziplining when this is all said and done,” she said. “I live on 25 acres and you have to be careful going for walks out on the land. There’s a tree house, a creek and some uneven spots, and I look forward to running around out there with my five year-old grandson.”

Copyright © September 2012 Ankle & Foot Care Centers

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Dr. Smesko Cooks Up Career and Work Balance

Back in college at Youngstown State University, Dr. Mark Smesko looked into many facets of medicine when trying to determine his specific career path. He didn’t have children at the time, but he knew a work/life balance was something he wanted to achieve.

“I didn’t know which field I would go into, but knew I wanted to work in medicine and I knew I wanted to be home for dinner every night with my family,” Dr. Smesko said. “An advisor sent me to the Ohio College of Podiatric Medicine, and it was there where I found the happiest doctors; ones with rewarding careers who seemed to have found the right balance in their lives.”

Fast forward 20 years and Dr. Smesko has built a successful practice at Ankle & Foot Care Centers. He sees patients in the East Liverpool, Salem and East Palestine offices, as well as a half-day per week at East Liverpool City Hospital Wound Center.

Meet the Doc

“My clinical interests are diabetic care, wound care, children’s foot and ankle care, and sports medicine,” he said. “In wound care, we see a lot cases related to diabetic conditions and it can be a rewarding feeling to follow a patient through his or her healing process. Sometimes you’re literally saving legs and feet.”

He also enjoys treating children, whose foot and ankle issues often involve warts, ingrown nails, a need for orthotics and various sports-related injuries. Dr. Smesko has a natural way with children – having three of his own ages 8 and under – and he’s built quite a referral and word-of-mouth network from how well he works with them.

A lifelong Mahoning Valley resident, Dr. Smesko lives in Canfield with his wife of 10 years and three children, ages 8, 6 and 4. He’s got a weakness for cooking shows and collecting cookbooks, and frequently stocks up on ingredients for his culinary creations in Pittsburgh’s Strip District.

Dr. Smesko Cooks Up Career and Work Balance

Dr. Smesko with his family on a recent vacation.

Copyright © September 2012 Ankle & Foot Care Centers

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Vicki Stoots: The Go-To Person for Insurance Claims

Vicki Stoots has seen her share of paperwork in her nearly 18-year career at Ankle & Foot Care Centers. As a certified professional coder she manages the practice’s 12-person billing office in East Liverpool.

The billing office handles the charges for all 18 offices, bills insurance companies for services provided and follows up on discrepancies. Although modernization over the years has moved a lot of paperwork online, she says today’s processes require much more attention.

Employee SpotlightWhat used to be a handful of insurance plans now numbers in the dozens – plus Medicaid and Medicare. Claims that used to sail through the payment system now regularly require more follow-up and resubmissions to insurance companies. And many of today’s claims require additional documentation, multiple forms and doctors’ requirements.

“While there’s a lot more to keep track of the online process is a plus,” Vicki said. “It’s a lot less physical paperwork and manuals. Everything is online now, such as viewing the status of claims and reviewing policies. It’s a big benefit that saves a lot of time.”

Vicki has been in billing in the East Liverpool office since she joined Ankle & Foot Care Centers after working in a similar capacity at a small hospital in the East Liverpool area. She credits the practice for how fairly it treats its employees. Vicki was hired by Dr. DiDomenico, one of the 3 founding members of AFCC, and attributes much of her work ethic to his influence.

“You don’t walk into his office without following all the steps, knowing exactly what you’re talking about, and anticipating every question he’s going to ask,” she said. “You go in there fully prepared. He’s taught us well, and I instill that quality in every new employee that comes in here.”

Outside of work Vicki enjoys archery, deer hunting, riding on her husband’s motorcycle, and she dabbles in golf.

“Golf is hard,” she said. “I just started playing and I don’t get to go on the big boy courses yet. Just par-3s right now.”

Copyright © September 2012 Ankle & Foot Care Centers

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Kids "Fall" Back into School Sports

As kids head back to school, they also get back into participating in team and individual sports. Children active in sports programs will improve their cardiovascular and musculoskeletal systems, coordination, and state of mind. In addition, sports help children make friends, have fun, learn to play as a member of a team, learn to play fairly, and improve self esteem.

Kids “Fall? Back into School SportsEvery child matures physically at his or her own rate and has a different degree of athletic ability. No amount of training can improve a child’s natural athletic ability, but training helps improve coordination and therefore performance. Parents should encourage their children to participate in sports but never forget that competition should be fun.

One of the most important ways to avoid injuries in all sports is stretching and warm-up exercises before beginning the activity. Warming up helps loosen muscles and prevents injuries in athletes of all ages. In addition, it’s extremely important to wear the correct shoes for the sport. Your podiatrist can help you choose the right shoes for your children.

According to podiatrists, overuse injuries occur from repetitive actions that put too much stress on the bones and muscles. All kids who play sports can develop an overuse injury. Foot injuries commonly seen in very active children include:

Blisters are caused by friction when shoes and socks rub repeatedly on the skin. Keep your child’s feet as dry as possible; wet shoes, boots and socks will cause blisters far more quickly than dry ones. Consult with your local podiatrist to ensure that shoes fit correctly and for treatment of blisters, especially if your child has diabetes.

Sever’s Disease is an injury to a child’s developing foot structure, specifically an inflammation in the heel’s growth plate due to muscle strain and repetitive stress. It is common in young athletes and children between 8-14 years of age, when the child’s bones are still in the growth stage and the growth plates have not become solidified. Rest, ice, and a padded heel insert--and in some cases, custom foot orthotics--are some treatments usually prescribed by a podiatrist for this condition.

Turf toe is a painful hyperextension of the big toe joint typically caused by playing on artificial turf or grass. Children involved in sports played on grass or turf (e.g., baseball, soccer, and football) should be particularly careful. The remedy is usually “RICE” (Rest, Ice, Compression, Elevation) and orthotics (custom devices for shoes) prescribed by your podiatrist.

Shin splints are micro-tears or inflammation of the anterior leg muscles that cause pain and discomfort on the front of the lower parts of the legs. They are often caused by repeated running on hard surfaces or overtraining at the beginning of a sports season. Some ways of preventing this injury are proper stretching and warm-ups, wearing shoes designed for your child’s sport, and custom orthotics (custom devices for shoes).

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

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From The Kitchen: Mini Turkey Meatballs

From The KitchenYield: 42 meatballs

1 small onion, grated
3 garlic cloves, minced
1 large egg
1/4 cup dried bread crumbs
3 tablespoons ketchup
1/4 cup chopped fresh Italian parsley leaves
1/4 cup grated Parmesan
1/4 cup grated Pecorino Romano
1 teaspoon salt
1/4 teaspoon ground black pepper
1 pound ground dark turkey meat
3 tablespoons olive oil
26 ounces Simple Tomato Sauce, recipe follows, or store-bought marinara sauce

Preparation time: 50 minutes (prep: 25 minutes, cook: 25 minutes)

1. Add the onion, garlic, egg, bread crumbs, ketchup, parsley, Parmesan, Pecorino, salt and pepper to a large bowl and blend. Mix in the turkey. Shape the turkey mixture into 1 1/4-inch-diameter meatballs. Place on a large plate or baking sheet.

2. Heat the oil in a heavy large frying pan over medium-high heat. Add the meatballs and saute until browned on all sides, about 5 minutes. Turn off heat. Transfer the meatballs to a plate. Pour off any excess oil. Add the marinara sauce, about 3 cups. Return all the meatballs to the pan. Turn the heat to medium-low and simmer until the sauce thickens slightly and the flavors blend, 15 to 20 minutes. Season the sauce, to taste, with salt and pepper.

3. Transfer the meatball mixture to a serving bowl. Serve with toothpicks.

Per serving: Calories 48; Fat 3 g (Sat. 1 g); Cholesterol 15 mg; Sodium 180 mg; Carbohydrate 3 g; Fiber 0 g; Protein 3 g

Simple Tomato Sauce
1/2 cup extra-virgin olive oil
1 small onion, chopped
2 cloves garlic, chopped
1 stalk celery, chopped
1 carrot, chopped
Sea salt and freshly ground black pepper
2 (32-ounce) cans crushed tomatoes
4 to 6 basil leaves
2 dried bay leaves
4 tablespoons unsalted butter, optional

1. In a large casserole pot, heat oil over medium high heat. Add onion and garlic and saute until soft and translucent, about 2 minutes. Add celery and carrots and season with salt and pepper. Saute until all the vegetables are soft, about 5 minutes. Add tomatoes, basil, and bay leaves and simmer covered on low heat for 1 hour or until thick. Remove bay leaves and check for seasoning. If sauce still tastes acidic, add unsalted butter, 1 tablespoon at a time to round out the flavors.

2. Add half the tomato sauce into the bowl of a food processor. Process until smooth. Continue with remaining tomato sauce.

3. If not using all the sauce, allow it to cool completely and pour 1 to 2 cup portions into freezer plastic bags. This will freeze up to 6 months.

Copyright © 2012 Food Network Magazine

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