Advanced Foot and Ankle

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afastaff — Fri, 21 Oct 2011 19:57:50 +0000

Save time and download your forms online! Please fill out the new patient packet before your first appointment.

Diabetic Foot Care

afastaff — Wed, 05 Oct 2011 18:05:39 +0000

Medicare Diabetic Foot Program

Advanced Foot & Ankle Center is an authorized Medicare Supplier which is qualified to evaluate, prescribe and dispense high quality shoes and 3 pairs of removable protective shoe inserts per calendar year. Many diabetic patients qualify for this benefit and Medicare will pay 80% of the cost for the shoes and insoles and your supplemental insurance should pay the other 20%.

The Medicare Therapeutic Shoe Bill was enacted by Congress in order to provide proper footwear and inserts for people with diabetes who qualify under Medicare Part B.

This program was designed to prevent complications such as lower limb ulcers and amputations for individuals who suffer from diabetes.

Who is Eligible?
Those 65 years or older and under the care of a Physician for Type I or Type II Diabetes and in the opinion of your Doctor have one (or more) of the required conditions specified on the Statement of Certifying Physician Form and are enrolled in Medicare Part B coverage.

What is Covered
Each calendar year, Medicare will pay 80% of the cost of:
a) One pair of extra depth shoes specifically approved for the diabetic foot.

b) Three pairs of heat molded multiple density inserts specifically made for the diabetic foot.

Additional Information
Medicare has an annual deductible that has to be met every year. The remaining 20% that Medicare DOES NOT pay, is usually covered by the patient’s secondary insurance or will be an out of pocket expense to the patient.
In most cases, we submit the Medicare claim on your behalf so the out of pocket cost to the patient is minimal. If you have a Medicare HMO, your benefits under the Therapeutic Shoe Bill must be administered and provided by the HMO.

Please feel free to contact our office for more information.

Please see the ADA website for more information

What are Warts?

afastaff — Wed, 05 Oct 2011 17:40:30 +0000

A wart is an infection caused by a virus, which can invade your skin through small cuts or breaks. Over time, the wart develops into a hard, rough growth on the surface of the skin. A wart is most commonly seen on the bottom of the foot (plantar wart), but can also appear on the top. Children, teens, and people with allergies or weakened immune systems are more vulnerable to the wart virus.

Symptoms
Warts may appear spongy, with tiny red, brown, or black spots. They can grow up to an inch or more across, occurring alone (solitary) or with smaller warts clustered nearby (mosaic). Warts are sometimes mistaken for corns or calluses. They can persist for years and recur in the same spot. If left untreated, warts can spread to other parts of the foot or even to the hands or other areas of the body.

Evaluation
Your podiatrist examines your wart carefully to determine that it is not a corn or callus. A wart will usually feel painful when your podiatrist squeezes it from side to side. To examine the wart further, the hard skin layer around it may need to be trimmed. A wart will have certain spots that bleed when trimmed; a callus will not.

How Does My Podiatrist Treat Warts?
There are many ways to treat warts, depending on their size and location. Medication or surgical removal, or both, may be effective treatments. A few of the possible treatment methods are described below; freezing or burning may also be used to treat warts. Even after warts are removed, they may recur.

Medication
The wart is broken down by applying an acidic medication. Blister-forming medication may also be used. Treatment may need to be repeated over several weeks.

Curettage
The wart is removed with a small, spoon-shaped instrument (curette). To lessen pain, a local anesthetic is often used with this procedure.

Laser
The wart is vaporized, using focused light energy produced by a laser. To lessen pain, a local anesthetic is often used with this procedure.

What Can I Do About Warts?
After your podiatrist treats your warts, protect your feet from future infection by keeping them clean and dry. If you’re thinking of using over-the-counter medications for warts, ask your podiatrist first. Some of these treatments can damage skin – and may be dangerous if you have diabetes or poor circulation.

Avoid going barefoot in public places like showers, gyms, and locker rooms. The wart virus may spread easily in moist settings like these. Wear thongs or sandals on your feet.

Sports Injuries

afastaff — Wed, 05 Oct 2011 17:39:52 +0000

While athletic activity can certainly benefit your general health, overuse injuries and even acute tendon tears and broken bones can occur.

Our treatment plans are tailored to return you to your previous level of activity as quickly as possible, while ensuring the best long-term outcome.

Sprains and broken bones can have identical symptoms. Bruising, pain and swelling are common. If you sustain a sports-related injury, an appointment with a podiatrist will allow quick diagnosis and appropriate treatment. Most sports-related injuries are non-surgical in nature. The primary treatment techniques include immobilization, oral anit-inflammatory medications and braces. If you sustain a more serious injury, such as a broken bone, your podiatris will identify whether surgical treatment will give you the best outcome.

Reconstructive Surgery

afastaff — Wed, 05 Oct 2011 17:39:22 +0000

Coming soon!

Sprains and Fractures

afastaff — Wed, 05 Oct 2011 17:38:46 +0000

Sprains and fractures of the foot and ankle bones are common and can result in long-term disability if not properly treated.

A sprain is a tear in the ligament that takes place when the ligament is stretched too far.

A fracture is a bone break that can happen in several ways. The most common break results when a ligament rips away a piece of the bone to which it was attached.

Pain and swelling accompany sprains and fractures, followed by discoloration due to injury to the small blood vessles around the injury. First aid can include application of ice to the injured area and keeping weight off the foot. You should seek professional help and advice from a podiatrist as soon as possible.

Skin Problems

afastaff — Wed, 05 Oct 2011 17:38:15 +0000

Our skin is the most accessible part of the body and often provides visible evidence of what is wrong inside. The most common skin problems seen by a podiatrist include contact dermatitis, warts and fungus.
Contact dermatitis is an irritating skin rash cause by a chemical coming in contact with the skin. The chemicals may be materials in shoes and socks. Removing the material from contact with the skin removes the problem.

Warts are often mistaken for corns or caluses, but they are growths cause by a virus that enters the skin through a break. Early diagnosis and professional treatment usually eliminates warts. Home treatment often is not effective and can result in greater damage.

“Athlete’s foot” is a common fungus that causes itching and irritation. A podiatrist treats this condition with oral and topical medication.

What are Neuromas

afastaff — Wed, 05 Oct 2011 17:37:38 +0000

Commonly called a Morton’s neuroma, this problem begins when the outer coating of a nerve in your foot thickens. This thicknening is usually caused by irritation that results when two bones repeatedly rub together (often due to ill-fitting shoes or abnormal bone movement). The area between the third and fourth toes is the most commonly affected; the area between the second and third toes is another common irritation point. Nerve problems due to diabetes or alcoholism may also cause neuroma-like symptoms.

Symptoms
The pain from neuromas may start gradually, causing burning, tingling, cramping, or numbness. Symptoms often occur after you’ve been walking or standing for a period of time. It might feel like you’re stepping on a lamp cord. You may need to take your shoe off and rub your foot. In some cases, the pain radiates from the tip of the toes to the ankle.

Evaluation
To help diagnose your problem and determine the best treatment for your neuroma, your podiatrist looks at your medical history, thoroughly examines your foot, and performs any necessary tests.

Medical History and Physical Exam
Your podiatrist talks with you about your symptoms, the frequency of your pain, and any past medical history that could involve nerve problems. Then your podiatrist examines your foot carefully, palpating (pressing) the area around the neuroma to determine the extent of your pain.

Tests
X-rays may be used to help identify a possible neuroma, or to rule out other causes of the pain. Ultrasound, which uses sound waves to show internal soft tissue, may also be performed. Another diagnostic test, which can also relieve pain, involves blocking the nerve by injecting anesthesia around it. Occasionally, magnetic resonance imaging (MRI) may be done to reveal cross-sectional images of soft tissue and bone.

How Does My Podiatrist Treat Neuromas?
After your evaluation, your podiatrist will talk with you about the most appropriate care for you neuroma. Nonsurgical treatment methods may include orthotics, medication, ultrasound, or shoe adjustments.

NONSURGICAL CARE

Orthotics:
Custom shoe inserts adjust the structural support of your foot, helping to prevent irritation to the nerve.

Ultrasound Therapy:
Sound waves may help reduce swelling around the neuroma.

Medication:
Cortisone injections or other medication can relieve pain and swelling in the nerve’s outer coating.

Shoe Changes:
Pads can cushion and support the parts of your foot that are vulnerable. Roomy, supportive shoes can help prevent irritation.

Will I Need Surgery?
If nonsurgical care does not help, surgery may be necessary to remove the neuroma. A local anesthetic may be used for the procedure. The surgery may be done in your podiatrist’s office, a surgical center, or a hospital.

After Surgery
Following your surgery, you may feel numbness (possibly permanent) in the area where the nerve was removed. Your podiatrist will tell you how soon you can be on your feet. Usually, you can return to normal activities within three to six weeks.

What Can I Do About Neuromas?
Shoes can make all the difference. Be sure they’re supportive — and roomy enough for your toes to wiggle. See your podiatrist if your symptoms continue or other foot problems arise.

Black and Blue Nails

afastaff — Wed, 05 Oct 2011 17:36:26 +0000

A black-and-blue nail is usually caused by sudden or repetitive injury to a toe. This might occur during sports that involve running or stopping quickly. The injury may also result from a heavy object falling on a toe. If your toe is black and blue but not injured, see your doctor immediately.

The big toe is most often affected. Bruised, broken blood vessels cause the black-and-blue colors under the nail. If the condition is the result of a sudden injury, pain may be severe.

To evaluate your condition, your podiatrist may talk with you about your symptoms and physical activities. He or she may palpate (press) the area at the end of the toe to determine the extent of pain. Your toe and foot are examined for any signs of infection. If a fracture or a bone spur is suspected, x-rays may be needed. If small black spots are present under the nail, other problems may need to be ruled out.

If pain is severe, the nail may be removed, or a hole may be drilled in the nail to allow drainage, which relieves the pressure. A local anesthetic may be used. Pain may also be relieved with prescription medications, or by soaking or icing the area. If pain is not severe, you may not need treatment. The nail can be thinned or left alone to fall off. A new nail should grow to replace it.

Many nail problems can be prevented by wearing the right shoes and trimming your nails properly. To help avoid infection, keep your feet clean and dry. If you have diabetes, talk with your podiatrist before doing any foot self-care.

To make sure that you are wearing the right shoes, get your feet measured (your size may change as you age). Wear shoes that are supportive and roomy enough for your toes to wiggle. Look for shoes made of natural materials, such as leather, which allow your feet to breathe.

To avoid problems from improper trimming, trim your toenails straight across without cutting down into the corners. If you can’t trim your own nails, ask your podiatrist to do so for you.

Thickened Toenails

afastaff — Wed, 05 Oct 2011 17:35:54 +0000

Abnormally thick or crumbling nails may be caused by injuries, pressure from shoes, fungal infections, or conditions such as diabetes, psoriasis, or vascular disease. Eventually, the nail may loosen and fall off.

Along with thickening, the nail may appear ridged, brittle, or yellowish. The nail may also feel painful when pressure is put on it.

Since thickened nails may be a symptom of an underlying medical condition, it’s important for your podiatrist to look at your medical history for possible related problems. To check for a fungal infection, a culture may be done. The thickness and color of the nail are also examined carefully to determine possible infections or other conditions.

If the nail isn’t infected, your podiatrist may be able to thin it by trimming, filing, or grinding. If a fungal infection is present, oral or topical antifungal medications may be needed. This can help prevent ulcerations under the nail while keeping the fungus from spreading to other nails. If pain is still present, the entire nail or part of it can be surgically removed. Do not remove the nail by yourself.