Posts for tag: Dr. Joseph Menn
With Memorial Day just a few weeks away, it is almost the start of beach season. This means it is time to pull those summer clothes out of hibernation and find some sun. For some, this is a nervous time of the year, as they are afraid to trade socks and shoes for sandals that show off their toenails. Many people with yellow, thick, crumbling nails are embarrassed to wear sandals.
Typically, nails turn thick and yellow because of fungus. In addition to causing athlete’s foot, fungus can attack the skin located under the nail plate. This is more common in the elderly as the immune system does not work as well. Unfortunately, fungus is very good at finding ways under the nail and once it gets in, it is hard to remove. As the fungus attacks the skin, it causes changes to the nail. The discoloration and changes to the nail shape and thickness is due to a buildup of dead skin and fungus. As the buildup increases, so does the nail height.
There are several options for treatment of discolored toenails. These options include oral medications, lotions, creams, drops, laser, and nail removal. The podiatrists at Coastal Podiatry Associates can offer recommendations to handle any discolored toenail. Not all medications work for everyone, so it is important to have a plan tailored to your needs and health. Visit a podiatrist if you are experiencing pain or are unable to trim the nail, as this can lead to further complications.
Diabetes can damage your nerves over time and lead to their deterioration and eventual death. Burning and tingling sensations are warning signs that your nerves are having a difficult time carrying messages from your brain to parts of the body. These sensations will eventually stop, but this occurs once the nerves stop functioning. The nerve damage is called diabetic neuropathy. Luckily, this process can be delay or even prevented by taking control of your diabetes. Here are some important facts.
1. Nerve damage is common among diabetics.
About half of the people with diabetes develop some type of neuropathy. This is because over time, high blood glucose levels will injure small blood vessels and nerves. The excess glucose damages the walls of small blood vessels preventing them from supplying nourishment to nerves.
2. Certain things increase your risk for nerve damage.
Diabetes and high blood glucose levels increase your risk of developing neuropathy. Smoking, high blood cholesterol and high blood pressure also increase your risk. Alcohol use and being overweight are other risks to develop neuropathy.
3. Symptoms may be unnoticed.
Symptoms of neuropathy include pain, burning or tingling sensations, and loss of feeling. These symptoms typically start in the tips of fingers or toes, as this is where the smallest nerves and blood vessels are found.
4. Neuropathy is diagnosed with an exam.
Along with your symptoms, a physical exam is used to diagnose neuropathy. Your podiatrist may test your feet to see how well you sense touch, vibration, and temperature. Nerve conduction studies can provide useful information as to the ability of your nerves to transmit signals.
5. Glucose control is the best prevention and treatment.
The most important method to improve blood glucose is to prevent further nerve damage. Good glucose control protects your nerves. In addition to daily blood glucose checks, follow a healthy eating and exercise plan. Talk with your doctor if you are having trouble managing your blood glucose, as many medications exist to assist.
6. Daily foot care is essential.
Neuropathy often starts in the feet. If you have lost feeling in your feet, you can develop an unknown injury. Untreated problems can quickly lead to infection and amputation. Check your feet every day for sore, hot, cold, numb, or dry spots. Look for bumps, cuts, sores, and swelling as well. If you notice any irregularities, make sure to tell your podiatrist. A yearly thorough foot exam by a podiatrist is recommended to monitor your diabetes.
For the past few decades, surgeons have used the same method to hold the toe in place after hammertoe surgery. Traditionally, they use a wire stabilize the toe for 4-6 weeks after surgery. This wire, known as a k-wire, runs down the middle of the bones in the toe, through the skin, and out the end of the toe. It is fast, technically sound, and inexpensive. Unfortunately, using the wire adds to the patient’s worry of a pin sticking out of the end of their toe, small possibility of infection, and the anxiety and discomfort of removing the pin.
Modern technology has allowed for newer forms of screws and staples to replace the k-wire. There are three different types of implants now available. The first type is heat moldable metal implant known as Hammerlock and Smart Toe. These implants are stored in cold temperature. Once they are inserted into the warm bone, the medal expands to grip and lock the bone. This prevents the implant and bone from moving. The next type of implant is known as a peg-and-hole style. These implants have two parts, with one being inserted into both sides of the bones needing to be fused together. Then, the two pieces are snapped together to create one stable implant. StayFuse and Pro-Toe are peg-and-hole implants. The last type of implant is the Arrow-LOK implant. This implant has a 3- dimensional arrow tip at both ends of a metal wire that allow it to grip and unite two bones.
These new methods have created options for surgeons and patients to choose from when decided on surgery. K-wires are still the gold standard, but newer implants offer patients the option of internal stabilization. It is important for patients to know their options and speak with their surgeon before any operation.
There are 19 muscles contained within each of your feet. Of these 19 intrinsic muscles, 18 of them connect to the toes. We spend most of our life in shoes where our toes cannot move freely and are not required to stabilize the foot. This lack of use causes these muscles to become weak. In addition, our choice of shoes can add more stress to these muscles by not allowing them to function properly. This makes it increasingly more important to exercise your toes. Strong toes help to strengthen your entire foot and prevent toe deformities such as hammer toes, claw toes, and mallet toes. The following exercises can be used to strengthen your foot and toes. These are useful for people already suffering from toe deformities and those looking to prevent such things.
Place a small towel on the floor in front of you while sitting down. Now using only your toes pick up the towel and bring it closer. Repeat this exercise 5 times. You can increase the resistance by placing a weight at the end of the towel.
Place 10-20 marbles on the floor. Using only your toes, pick up one at a time and put each marble in a bowl. This exercise also helps those with pain in the ball of the foot.
Place a thick rubber band around all of your toes. Next, try to spread your toes as far apart as possible. Hold each attempt for 5 seconds and repeat 10 times.
Place small corks or something similar between your toes. Next, squeeze your toes together and hold for 5 seconds. Repeat 10 times.
Any chance you get, take off your shoes and walk in the sand. This will massage and strengthen your toes and feet.
Ankle pain is an extremely common complaint after ankle injuries. For injuries that continue to have symptoms of pain, swelling, grinding, or instability after treatments of rest, ice, bracing, anti-inflammatory medicine, and time, an ankle arthroscopy is a great option. Arthroscopy is a surgical technique that involves the use of a small lens to view and treat a joint.
An arthroscope is an elongated tube with a magnification lens and a camera so the surgeon can inspect the joint. For ankle scopes, the arthroscope typically measures 2.5-3.5 millimeters in diameter. The surgeon will create 2-3 portals to gain access into the ankle joint. Through one portal, the scope is placed to view the joint and through the other openings, small instruments are passed. These instruments are used to remove the problematic tissue. The length of ankle arthroscopy procedure varies but is typically around 30 minutes. After surgery, the ankle is wrapped in a soft bandage and can be walked on immediately.
Not all causes of ankle pain can be treated with a scope procedure. A common use for an arthroscope is cartilage damage. This is commonly found in people who have sustained injuries to the ankle joint. A scope is used to assess the areas of cartilage damage and try to restore the normal cartilage surface of the joint. Bone spur removal is another use for ankle scopes. Bone spurs can from in front of the ankle joint, causing bones forming the ankle to pinch when the foot is moved towards the leg. Ankle arthroscopy can be helpful whenever there is a condition causing the accumulation of loose debris or scar tissue within the ankle joint. Removal of this tissue can help restore motion and decrease swelling and pain. Ankle arthroscopy is not for everyone. Talk to your doctor about this procedure if you are experiencing ankle pain or swelling.