The Voice of Podiatrists

Serving Over 12,500 Podiatrists Daily

March 25, 2011 #4,117 Publisher-Barry Block, DPM, JD

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Fashion-Conscious Women Pay a High Price: NJ Podiatrist

Famed shoe designer Christian Louboutin loves wearing comfortable sneakers but says, for women, it’s far more important to look good than to feel good. Louboutin, a diminutive 47-year-old Frenchman, equates “comfort” in fashion with ugliness. Meanwhile, scores of women who wear high heels every day end up with major foot and other problems, such as back pain, bunions, corns, calluses, stress fractures, hammertoes, and nerve damage. 

Dr. Morris Morin

“Women do love their high heels, but if you wear them all the time, significant foot pain and other problems can ensue, either as a direct result of the heels or exacerbated by them,” according to Dr. Morris Morin, director of podiatric medicine at Hackensack University Medical Center.

Source: Samantha Chang, The Improper [3/23/11]

Scholl Alumni Association Raises More Than $60,000 for Student Scholarships 

The Alumni Association of the Dr. William M. Scholl College of Podiatric Medicine at Rosalind Franklin University of Medicine and Science hosted its 28th Annual Scholarship Benefit on March 4 at the Hyatt Regency Hotel in Chicago.   

(L-R) Drs. Nancy Parsley, Marlene Reid, Kathleen Stone, and IPMA Executive Director Mary Feeley

That evening, thanks to the generosity of Bako Podiatric Pathology Services, Dr. Comfort, the Midwest Podiatry Conference, the Podiatry Insurance Company of America and the Illinois Podiatric Medical Association, as well as countless individual donors, the University raised more than $60,000 for the Scholl Scholarship Fund.

NH Podiatrist Participates in AIDS Fundraiser

While HIV and AIDS may not be as prominent in today's culture as it was in the 1980 and 1990s, the importance of education and fundraising was the theme of the second annual AIDS Response Seacoast (ARS) garden party. As a podiatrist with a practice in Rochester (NH), Dr. Billie A. Bondar said she occasionally treats people with the disease and even lost a friend to it. "I'm very happy to partake (in the Garden Party) and help because it certainly needs to be tackled.

Dr. Billie Bondar

I went to Africa, and it gave me an eye opener. I went to an orphanage where all the kids had lost their parents to AIDS so that sits in my head." Bondar pointed out that the disease doesn't just affect younger patients and that she has seen clients ranging from their 30s to their 70s. "People are alive and kicking," she said, "But they're still ill."

Source: Aimee Lockhardt, Foster's Daily Democrat [3/24/11]

Bail Set for Retired FL Podiatrist Accused of Attempted Murder

A Brays Island man charged Tuesday with attempted murder in a Thanksgiving-eve family gun battle with his nephew will be released from jail after posting $10,000 and turning in his weapons and his passport, a magistrate judge ruled today. A Beaufort County Sheriff’s Office official argued that Dr. Richard Santee, 68, was a potential flight risk. There was also concern about his extensive gun collection, that he would harm himself or others.

Santee is accused of attempting to kill his nephew, James Piotrowski, 42, of Stuart, FL during an argument Nov. 24 at Santee’s home, where family had gathered for Thanksgiving. Santee, a retired podiatrist, has owned property at Brays Island for more than 20 years and lived there for seven years.

Source: Cassie Foss, The Island Packet [3/23/11]

Query: Obesity and Foot Pain

We have a society that is overweight and getting worse. I see many patients every week who are 300–350 pounds and more, with foot pain, metatarsalgia, tendonitis, PTTD, stress fractures, plantar fasciitis, and heel pain. I think that most everyone would agree that many of these conditions would be dramatically improved with weight loss. I occasionally get individuals to lose weight, but for the most part, this is a wasted effort and I sometimes offend some patients.

How are my colleagues addressing this issue, and does this result in weight loss? Is there any consensus that this topic should be ignored or addressed?

Scott Shields DPM, Enid, OK

Dizziness from Urea Cream? (David Weiss, DPM)
From: Elliot Udell, DPM
 
Dizziness as a side-effect associated with 40% urea creams appears to be lumped in the adverse warnings under the category of rare allergic reactions. If allergy is indeed thee culprit,  even though patients use the cream externally, while they are rubbing it into their feet, they are breathing it in. For the average person, there would be no side-effect, but if a person is highly allergic to the urea or any of its added components, upper respiratory symptoms could develop which could include the inner ear. This would therefore explain the dizziness.

One might ask the question: "if it's an allergic reaction and affects  the inner ear, why does it not cause a contact dermatitis where it is being applied?" One might expect the area where the medication is applied to become red and itchy. As an allergy sufferer, I become congested, get itchy eyes, rhinitis, dizziness, tinitis, and even wheezing from pollen, but I can touch concentrated  pollen on a tree which I do regularly as a gardening enthusiast, and do not develop any skin reactions. On the contrary, I develop a burn-like rash from certain adhesive dressings, but if I smell them, I don't develop upper respiratory problems.
 
Elliot Udell, DPM, Hicksville, NY, Elliotu@aol.com

RE: Current Views on Regranex Gel (Greg Caringi, DPM)
From: Elliot Udell, DPM

In our practice, we have been using Regranex since it was first released. It is highly effective. The recommendation is that you not use more than three tubes because of blackbox warnings. The problem that we encounter with Regranex is the cost. It is now over $850 a tube, and if patients do not have medical coverage for medications, they may be resistant to buying this medication. Hence, we try other lesser expensive options first such as Amerigel and the myriad of other wound care products available. A big problem with Regranex is compliance. Many people will not apply it daily, either because they don't want to pay for it, or there is an inability to physically reach their feet or mentally comply with a daily wound care regimen.

In any case, home care nursing should be brought into the picture. One effective trick we found when we suspect a lack of compliance is to have the patient bring the tube of Regranex to the office (in a cooler with ice). That way, we can monitor whether they own the tube as well as whether they are using it. In cases where we want to use a medication with growth factors and the patient cannot afford Regranex, there are other growth factor containing graft products such as Apligraft, Dermagraft, and some new products that are coming out.

I attended a workshop on an exciting new product called Grafix which contains both growth factors and mesenchymal stem cells. The doctors at the workshop who already use this product reported outstanding results.
 
Elliot Udell, DPM, Hicksville, NY, Elliotu@aol.com

RE: Test for Raynaud's (Bryan Markinson, DPM)
From: Robert Bijak, DPM   

Of course, Raynaud's can be primary, (vasomotor) or secondary (associated with systemic disease). Cryoglobulins CAN be of value in differentiating the two. Primary vasomotor Raynaud's is usually negative for cryoglobulins, but secondary is often associated with positive lab results for cryoglobulins. So, along with vascular studies for vasospasms and a blood test, you can make a good estimation of which condition you're dealing with, the disease or the phenomenon. As such, I recommend a blood test for completeness.

I would be remiss if I didn't remind us of the cold agglutination hemolytic antibody disease which can manifest itself as cyanosis in the extremities (ex. acrocyanosis). These agglutinins are different from cryoglobulins. The lab, clinical manifestations, similarities and differences between these conditions are worth reviewing. Not everything is Raynaud's.

Robert Bijak, DPM, Clarence Center, NY, rbijak@aol.com

RE: CWS Exam Prep Materials/Courses (Allan Doan, DPM)
From: Mark Weinstock, DPM

The American Professional Wound Care Association (APWCA) offers a fantastic review/preparation course for certification in wound care. You can easily find any necessary information about this wonderful, readily available resource at apwca.org or by calling (215) 364-4100.

Disclaimer: I am a fellow member of the APWCA.

Mark Weinstock, DPM, Maywood, NJ, dpm109@aol.com

RE: Oil for Ritter Surgical Table (Robert K Hall, DPM)
From: Les Wolff, DPM

Try hydraulic Jack Oil(GUNK). It is available at most auto supply stores

Les Wolff, DPM, San Francisco, CA, hydedoc@pacbell.net

RE: Replacement Product for Panafil (Wm. Turner, DPM)
From: Robert Wunderlich, DPM
 
In response to Dr. Turner's concerns regarding the removal of Panafil/Accuzyme and other papain-based debriding agents from the market, the action taken by the FDA was to order companies to stop marketing and manufacturing UNAPPROVED drug products that contain papain in a topical dosage form. Neither Panafil, Accuzyme, nor ANY papain-based topical agents were ever FDA-approved. 

The FDA's rationale involved several safety concerns, as well as the fact that the effectiveness of these products is not supported by scientifically sound studies in the medical literature.  It is possible that these products may gain FDA-approval at some point in the future, and it is up to the manufacturers of these products to pursue that course. For more information on this decision by the FDA, see: tinyurl.com/6ezjmky
 
Robert Wunderlich, DPM, San Antonio, TX, rwunder@gmail.com

RE: Homeopathy is a Safe Way to Complement Treatment Choices: IL Podiatrist (Dan Waldman, DPM)
From: Robert Boudreau, DPM

I refuse to be called "crabby" because I do not accept anecdotal studies showing that 1/100,000 of a dram of snake-oil injected via whichever route of administration is "in the protocol" the cause of remarkable cures for patients. Let's call it what it is: placebo therapy.
 
Robert Boudreau, DPM, Tyler, TX, rbftdoc@aol.com

ASSOCIATE POSITION - EAST TEXAS, DELAWARE

Looking for podiatrist to see patients in Nursing Home Facilities in East Texas and Delaware. AVAILABLE IMMEDIATELY.  Please contact me at doconcall@aol.com.

POSITION AVAILABLE – NEW YORK
 
Well-established, multi-doctor podiatry practice with offices in Putnam and Westchester counties. Compensation based on productivity. Excellent opportunity for recent residency graduate to build skills and learn practice management. Full-time preferred but right part-time candidate will be considered. Email cover letter and CV to: Podiatry2011@gmail.com

ASSOCIATE POSITION - TEXAS

Are you looking for a busy, well-rounded practice experience?" Group practice in DFW area looking for a 3-year surgically-trained associate with a sports medicine background. Needs to be as comfortable making orthotics as fixing a complex flat foot. Email CV to crane@faant.com

ASSOCIATE POSITION - NYC, NY

ASSOCIATE POSITIONS – MARYLAND

Are you motivated, personable and enjoy working with the elderly? We are offering full or part-time positions in Maryland. Our group, Podiatry Management Services, provides care to the elderly in Nursing Homes, Assisted Living, Senior Homes, Adult Daycare and other similar facilities. Please e-mail your c.v. to drhprosen@verizon.net or fax to 410-486-2049 or call Dr. Herbert Rosen at 410-580-0255.

ASSOCIATE POSITIONS - TEXAS

Podiatrists needed in San Antonio or Austin. Great paying positions for full or part-time physicians. Established, unique mobile podiatry practice servicing senior living facilities. Office locations in both cities with excellent support staff for your assistance and scheduling. Check us out before looking elsewhere. See us at www.footmobile.com.  Reply with cover letter and CV to doctor.cohen@yahoo.com with a cc: to lisa.schulze@yahoo.com or call us at 210-495-6477 or 210-545-3338.

POSITION AVAILABLE – PHOENIX, ARIZONA

Full-time or part-time position available for an associate to join a modern, well established practice. Needed is a motivated, hard-working, well-rounded, surgically-trained podiatrist to complement our office. Excellent income potential with possible partnership opportunity available. Arizona license required. Email CV to Foot.doctor@hushmail.com.
 

ASSOCIATE OPPORTUNITY - FREDERICKSBURG, VA

Progressive, busy practice seeks personable, ethical, confident associate interested in future partnership. Lucrative opportunity for self-starter with strong work ethic. State-of-the-art office in rapidly growing community with two new hospitals and new surgery center. Practice has excellent reputation with well established referral base. Cover letter/CV to: fredfeet@verizon.net

ASSOCIATE POSITIONS - NW INDIANA, CHICAGO AREA

2 Full-Time positions open - One for Northwest Indiana and one for the Chicagoland area. Must have 2-year surgical residency. Must be motivated and a self-starter. State License required. If interested email: f-massuda@footexperts.com

EQUIPMENT FOR SALE - DOPPLER, SURGICAL INSTRUMENTS

Koven Technology Smartdop 45 hand-held bi-directional vascular ultrasound Doppler with real-time waveform LCD - like new in carry case. all attachments for ABI and Digital PPG & PVR. AC charger and computer cords included. Also available are surgical hand instruments, rasps, Weitlanders, stats, needle holders, retractors, and more. Email. Podassociate@aol.com

EQUIPMENT FOR SALE -  SONOACE ULTRASOUND

2007 Sonoace, Pico color ultrasound image, Medison, MY202C MAI, 7.5 mhz small head, hl59edn, 40 mm, 4 modes - 2d, Doppler, 3-D, and multi-image. $9,800 or best offer. Just finished servicing by Universal, includes Sony black and white printer. Charles W. Kelley III, DPM cwkell@aol.com

EQUIPMENT FOR SALE - COOL TOUCH LASER
 
Cool Breeze Cool Touch CT3 plus laser used for ugly, unsightly, toe nail infections. Less than six months old. Great price won't last long. Considering a laser? We also have the Q- Clear Q- switch laser too. This laser is perfect for you. Also a used Lumix 2 laser, best price today   Dr. Zuckerman is in the Fort Lauderdale area and will demo this lasers on your patients. E-mail footcare@comcast.net

PRACTICE FOR SALE - WASHINGTON STATE - SUBURBAN SEATTLE

16 year established part time practice. Includes Midmark 417 (4 position keypad), Excel X-ray, processor, Ritter M9, instruments, bandaids, etc. 1 Day/week $50K gross. Professional Business appraisal at $48K. Asking $35K. Shared office with 2 FP's. Easily expandable. Reply: practiceforsale18@yahoo.com

PRACTICE FOR SALE - MARYLAND, DC SUBURBS

Great opportunity. Well established and equipped practice for sale. Office includes state licensed Ambulatory Surgical Center. Present owner is retiring but will stay on as needed for smooth transition. Average gross over past 3 years is $575 K. dpmpracticeforsale@yahoo.com

SPACE AVAILABLE- NYC & LI

Office to sublet and share - East 60th Manhattan, and Plainview long island. access to an MRI, Joint Commission certified operating rooms, digital x-ray, diagnostic ultrasound, and access to a multi-specialty ambulatory surgical center. Turn-key operation - no investment needed 516 476-1815 PODO2345@AOL.COM

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