Continuous Chest Compression (CPR)

According to a recent medical study from The University of Arizona, every three days, more Americans die from sudden cardiac arrest than the number who died in the 9-11 attacks. You can help reduce these numbers drastically by learning this modified version of CPR – which does not require mouth-to-mouth contact. This version of CPR, called Continuous Chest Compression, makes it easier to assist in the event of an emergency – and the video in this link is very easy to watch.

Continuous Chest Compression (CPR)

For more information, click here.

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Helpful Tips for Finding Shoes that Fit Properly: Comfortable Shoes That Make Your Feet Feel Great!

It’s best to shop for shoes at the end of the day, when our feet are swollen. Normally, body fluid will accumulate in our feet after a day of work or standing. Purchasing shoes at this time of day will provide a most accurate fit. Swelling is a  normal response to organ function, and it can be easily relieved by elevating our feet and legs above heart level for 15 to 20 minutes. If this doesn’t relieve it, consult with your doctor.

Most of us have one foot that’s larger than the other. We must purchase the shoe size which will fit the larger shoe. One can purchase a foot lining to add to the shoe that will accommodate the smaller foot—and this should eliminate movement associated with the larger size.

Our shoe size changes throughout life. There are many reasons why this happens and this process is usually normal. There are some situations where an increase in an adult shoe size could be a problem indicator and in this situation, consultation with a Podiatrist is most appropriate.

It’s best to place our feet in a Brannock device (http://www.brannock.com) each time we purchase shoes. This is a metal instrument which has been first prototyped in 1926, and it is considered the gold standard for shoe measurement. This will always provide the most accurate shoe size requirement information. It’s best to be familiar with this device and demand this type fit analysis at the time of each purchase. Add the width of your thumb nail to the end of your longest toe. Most of us believe that our great toe is the longest toe, however the second or third toe may be the longest. Add this length to the longest toe and you may save the expense of visits to a Podiatrists office.

New shoes should feel good right away. Years ago we used to think that we needed to break in shoes for a more eventual “good fit”. This isn’t the case today. Put the shoes on in the shoe store and if they both feel good, take them home and wear them on a carpeted floor for a few days. If after this in home trial, comfort is confirmed, random shoe use is the next step. If however, the shoes don’t feel good at home, you should return them for a different size.

As I recommend shoe trees on a daily basis, I am surprised at the number of patients that mention that they never have heard of them. (http://tinyurl.com/254b5g9) Shoe trees are made of cedar, plastic and paper. I routinely recommend the cedar shoe trees. They should be used in all shoes. They will prolong twice the life of the shoes, and maintain their original shape.  Shoe rotation is another good practice since this will maintain a healthy shoe environment and aid in increasing shoe life. Our feet perspire daily and this perspiration is harbored in our shoes. Even though some shoes breathe better than others, shoe rotation or never wearing the same pair of shoes two days in a row will aid in reducing the likelihood of developing athletes foot.

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What is the Difference Between a Podiatrist and an Orthopedic Surgeon? And What Does this have to do with You?

Many patients struggle with the choice of the correct doctor to treat their foot pains. Often the choice varies between an Orthopedic surgeon and a Podiatrist. Clarification of the difference between these two specialties will be outlined in this blog post:

Both Podiatrists and foot and ankle specialized Orthopedic Surgeons are well trained. Podiatrists study medicine as it relates to feet, specifically, during their entire course of study, and therefore they do have more years of study that is focused specifically on feet. The basic Podiatric education lasts for four years after college. Following this basic and focused training, a Podiatrist will undergo residency training which may last up to three years. They are doctors, with many years of study and experience in providing foot care.

To become an Orthopedic surgeon, you must first become an MD, then go into Orthopedic medicine, specializing in foot and ankle surgery—this specialization occurs in the form of a fellowship which usually lasts for one year. So the Orthopedic surgeon would have the better general medical background, but less time spent learning specifically about feet.

Of course, an Orthopedic surgeon specialized in foot/ankle IS primarily a surgeon, so naturally his approach to foot care usually focuses on surgery. An Orthopedic surgeon will apply general orthopedic principles to the foot which is a very unique structure and not like other parts of the body.

A Podiatrist is inclined to look at ALL the possible treatments for a patient’s condition and to recommend surgery only if other approaches have not been successful. In fact, not all Podiatrists do internships in foot surgery; some do not do surgery at all. But there are other Podiatrists who specialize in surgery. All surgeon Podiatrists must be certified by the American Board of Podiatric Surgery to perform surgery in any hospital or participate in insurance plans. This board has very strict requirements for appointment, and recertification is required every ten years. These Podiatrists do several surgeries per week and are very expert and well-practiced in foot surgery.

At this time, the residency requirement for Podiatrists varies from state to state. The American Podiatric Medical Association has pledged that by the year 2015 all Podiatrists will have completed a three year residency program before they begin practice.

I am board certified in foot surgery by the American Board of Podiatric Surgery and have fellowships in the American Society of Podiatric Surgeons, American Academy of Practice Management and the American Professional Wound Care Association.

Many of the surgical procedures and techniques which are used in the operating room on a daily basis have been discovered by Orthopedists and refined by Podiatrists. We, as Podiatrists, have realized that this unique structure of the foot requires unique and special treatment/procedures which aren’t necessarily used in the rest of the body. This body appendage, which consists of 28 bones, must carry our bodies throughout our lives, often without required maintenance. It has been estimated that our feet will travel over 150,000 miles in a lifetime.

Give your feet the attention that is necessary, since one pair must last a lifetime—see your Podiatrist.

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Tips on Finding a Good Podiatrist

In this day of the internet, the credentials of any doctor are usually readily available. This is the first step in finding a competent/well trained Podiatrist. If this information isn’t available on the web, phone contact with the office is recommended. Many Doctors of Podiatric Medicine (DPM) have other accomplishments/degrees listed after their name. These may include PhD, DO etc. This type designation indicates that the DPM has gone back to school and obtained additional training in another specialty. Board certification is one important credential that must be verified. Podiatric Surgery Board Certification is regulated by the American Board of Podiatric Surgery. To become certified by this board, one must complete a certified residency program for one to three years, document a specified number of surgical cases, and pass the written and oral examinations. Once board certified status has been achieved, a DPM may list the designation diplomat of the American Board of Podiatric Surgery after his name.

Fellowships in other related organizations may be obtained by meeting specified requirements which include oral or written examinations.

Calculating the number of years which the DPM has been practice will help determine the “seasoning trait”. Every physician is very book smart by the time he/she graduates medical school.

If a residency program is attended, then a physician is well versed in the residency training which he or she has received. Unfortunately, even a great residency program includes long term follow up care and evaluation of patients. It’s this long term follow up and evaluation that helps establish treatment guidelines and preferences in each physician. The resident is guided down this path by the attending surgeon in the residency program, but there is no substitute for first hand experience. Since this experience is obtained over time, a well seasoned DPM should have been in practice for at least ten years.

Recommendation is the next important factor in selecting a DPM. Of course your primary physician’s choice would be most valuable in this process; however additional research is always very helpful. Ask the advice of your friends and relatives when selecting a new Podiatrist.

Beware of random choices based on nationality association, free exam advertisements or identifying a certain problem with an advertisement. In an ideal world, a physician shouldn’t have to advertise—his reputation should be on the street and  readily available following the appropriate query.

In conclusion, the first encounter is a very important one. If you don’t feel that you have been properly treated and satisfied with the one on one time spent by your physician, this is the time to search out a new one. We must have confidence in our physicians as this will help guide us through our treatment programs; without this confidence, any treatment is doomed to failure.

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