The Voice of Podiatrists

Serving Over 12,500 Podiatrists Daily

August 03, 2011 #4,223 Publisher-Barry Block, DPM, JD

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Treat Toning Shoes Like Fitness Tools: MN Podiatrist  

The popularity of "toning" shoes, whose unstable soles require you to work muscles harder to stay balanced, suggests consumers are banking on it. Podiatrist Dr. Paul Langer of Twin Cities Orthopedics in Minneapolis said that although muscles likely do work harder to overcome the instability of the shoes, he is skeptical that it's to the extent that it will actually burn fat and boost muscle tone.

Dr. Paul Langer

What they can do, Langer said, is redistribute the pressure on your foot, alleviating stress and strain on the joints, which is helpful for people suffering from arthritis in the foot. People should treat the shoes like fitness tools, Langer said. The most problems he sees are from overuse.

Source: Alexia Elejalde-Ruiz, Chicago Tribune [7/31/11

CO Podiatrist Elected President of AAPSM  

James D. Yakel, DPM, a sports medicine podiatrist in private practice in Brighton, Colorado, was elected President of the the American Academy of Podiatric Sports Medicine (AAPSM) at the Annual Meeting held last week in Boston, Massachusetts. Dr. Yakel received his Doctor of Podiatric Medicine Degree from the Ohio College of Podiatric Medicine. In addition to being a Fellow and President of the AAPSM, Dr. Yakel is a Fellow of the American College of Foot and Ankle Surgeons, the American Board of Podiatric Surgery, and the American Professional Wound Care Association.        

(LTR) Drs. Karen Langone, Jamie Yakel, Rob Conenello, Dave Jenkins, Dianne Mitchell, Paul Langer and AAPSM Executive Director Rita Yates.

Also elected were: President-Elect- Robert Conenello, DPM, Orangeburg, NY; Vice President- Paul R. Langer, DPM, Minneapolis, MN; Secretary/Treasurer- David Jenkins, DPM, Glendale, AZ and newly elected Director – Dianne Mitchell, DPM, Sacramento, CA. Karen Langone, DPM, Southhampton, NY serves as Immediate Past President.  Rita J. Yates, of Walkersville, MD, serves as AAPSM Executive Director.

AAPSM Presents Awards at Annual Meeting  

The American Academy of Podiatric Sports Medicine (AAPSM) presented the following awards during the meeting:

(L-R) Drs. Tim Dutra and David Davidson; Brian Fullem (accepting for Amol Saxena), David Davidson

2011 Richard Schuster Award to Amol Saxena, DPM (Brian Fullem, DPM accepted the award on his behalf), and the Robert Barnes Distinguished Service Award to Timothy Dutra, DPM.

MA Podiatrist Receives University of Sapienza Recognition Award

Dr. Joseph Addante was presented the University of Sapienza Recognition Award by Dr. Mauro Montesi, President of the Medical Faculty of the University of Sapienza in Rome, Italy. The award was in recognition and appreciation for Addante's efforts toward the development of podology education over the past 15 years. Podology has advanced from a diploma course to a college degree. There is also the option of pursuing a masters degree in diabetic foot care.

(L-R) Drs. Joseph Addante, Mauro Montesi, Joseph Caporusso, and Michael King

The award presentation was presented at the APMA National Scientific Meeting in Boston. Members of the FIP organization were present with  representation from Italy which is promoting the World Congress, held in Rome October of 2013.

Let Patients Lead

To connect well with patients, take cues from their speech. Match the type of words and tone they use. For example, if they speak in simple words, tone down your vocabulary.

In fact, use the  same words when possible. If a patient describes a situation as an “issue,” don’t use the word “problem” when you talk about it. If the patient says "I have a bunion," don't use the term "hallux valgus."

Mirroring patients’ speech patterns more easily builds rapport because they will consider you to be like them.

Source — Adapted from “10 Q,” Greg Callaghah, The Australian Magazine,via Communication Briefings

Query: Pulse Dosing regimen for Sporonox

What is the current pulse dosing regimen of Sporanox for onychomycosis?

Bill Trabulsi, DPM, Tampa, FL.

Query: EBM Studies for Class-Four Lasers

Can anyone comment on their experiences or direct me to "real studies" on Class-Four lasers such as would stand up to the standards by which we evaluate efficacy of drugs, surgery, methods, etc?  

Charles Perry, DPM, Cambridge OH

Query:  Denial, Diabetic Shoes

Medicare recently denied diabetic shoe reimbursement due to "not enough information provided." I used ICD-9 250.00 (diabetes mellitus without mention of complication, type II, controlled) as stated on MD's statement along with ICD-9 707.1 (ulcer of lower limbs, except pressure ulcer). I used modifiers KX-RT-LT.  Any ideas?

Karen, Office of Lawrence Kaminsky, DPM, Laguna Woods, CA

Response: The simple answer is your secondary diagnosis code was not taken to the 5th character. Recheck the diagnosis.

If it was an ulcer of a toe, then the correct code would be ICD-9 707.15 (ulcer of other part of foot; toes).

If it was an ulcer of midfoot-heel, then it would be ICD-9 707.14 (ulcer of heel and midfoot).

David J. Freedman, DPM, CPC, Silver Spring, MD

Codingline subscription information can be found here
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RE: Surgical Considerations for Chronic Smoker
From: Charles Morelli, DPM

The sentence "Surgical Considerations for Chronic Smoker" is an oxymoron, especially for an elective procedure  I do not understand the logic behind putting an absorbable pin in a toe, not to mention a 5th toe, in a diabetic who smokes. If you've never seen a sausage toe, or had an angry patient with a swollen toe, I think you just might have that pleasure in your future.
 
If the patient wasn't a diabetic who smoked 1 PPD for the majority of his adult life, and if you really want to use an implant on a 5th toe (which I've done and they do work well), consider either the 14mm hammerlock or smaller DIPJ smart toe implant by MMI. And you need to reduce the abduction at the MPJ as well. This is a lot of work for a small toe IN A DIABETIC WHO SMOKES. My suggestion is to refer him to your competition. You will sleep better.
 
Charles Morelli, DPM, Mamaroneck, NY, Podiodoc@gmail.com

RE:  2011 APMA Scientific Meeting One of the Best Ever
From: Elliot Udell, DPM
 
Congratulations to all of those who worked so hard to make this past APMA national convention a great success. Nothing was missing.
 
One facet of the program that was really exciting was the presence of many lectures which were based on evidence-based medicine. Not only did speakers support presentations by quoting from the literature, but there were actual slots in the program where doctors presented their own original research projects. In addition, there was an entire hallway of abstracts and posters on research projects conducted by our colleagues from all over the country.
 
A quarter of a century ago,  this was not the case. Lectures were not supported by clinical research. Speakers supported their ideas solely on their personal reputations and positions of status held within podiatric institutions. Any research quoted tended to be that done by non-podiatric physicians at non-podiatric centers.
 
This change is not just a change of format at a seminar, but represents a profession which is becoming its own. By doing research, we are designing our profession's own destiny. We are no longer doctors who have taken clinical ideas from other professions and packaged it under our own degree, but we are conducting the studies and developing treatment regimens that will be practiced by our colleagues, as well as other healthcare professionals. This alone will lead to greater respect and status among the rest of the healthcare community.
 
Elliot Udell, DPM, Hicksville, NY,Elliotu@aol.com

RE: Polydactyly Record Set

A one-year-old boy in India has broken a world record after being born with 34 fingers and toes. Akshat Saxena had seven fingers on each hand and ten toes on each foot, according to a spokesman for Guinness World Records.

Ten Toes on Each Foot

The child, from Uttar Pradesh in northern India, has since had a series of surgeries to amputate the excess digits. Akshat was born last year without thumbs so doctors are working to reconstruct these out of the fingers they have removed.  

Source: Daily Mail [7/26/11] via Dr. Bret Ribotsky

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