The Voice of Podiatrists

Serving Over 10,800 Podiatrists Daily

April 21, 2008 #3,225 Editor-Barry Block, DPM, JD

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NY Podiatrist Honored at Working Women Reception

Kathy Fallon, DPM of Armonk, NY was one of fourteen women from Westchester selected to receive a Working Women of Westchester Award at a gala reception hosted by the Westchester County Business Journal.

Famed Prosecuter Jeannine Pirro (L) with Dr.Kathy Fallon

Fallon is the creator and producer of the songs books and CD’s Heavenly Lullabies and Heavenly Skies and Lullabies, which have raised tens of thousands of dollars for the children of the victims of 9/11 and the children of the victims of Hurricane Katrina.

Brook Selected as Official Podiatrist to Dallas Cheerleaders

Dr. Joel Brook of Dallas, TX has been selected as the official podiatrist to the famed Dallas Cheerleaders. Brook is a 1995 graduate of the Temple School of Podiatric Medicine and was chief resident in the Department of Surgery, Division of Podiatric Surgery, at Mount Sinai Medical Center in Cleveland, Ohio.

Dr. Joel Brook with Dallas Cheerleaders

Dr. Brook has served on the infection control, ethics and executive committee of the ambulatory surgery center at Medical City, and was chairman of the Podiatric Surgery section at Medical City Dallas Hospital from 2001-2007. Dr. Brook was voted Best Doctor in D Magazine for four years.

OH Podiatrist Pleads Guilty to Drug Charges

A podiatrist pleaded guilty Thursday to a federal charge of conspiring to distribute oxycodone. Dr. Mark Stieby, 37, faces up to 20 years in prison when U.S. District Judge Danny Reeves sentences him on July 14 in Covington. The plea avoided a trial that was to begin April 29. Stieby admitted to writing prescriptions for oxycodone to three patients in exchange for some of the pills to feed his own addiction to pain medications. Stieby took at least 610 of them, according to court records.

Stieby was also writing Percocet prescriptions for the patient's girlfriend, according to court records. The prescription was originally for 40 pills per week, but was bumped up to 60 pills per week in October. Sometimes Stieby would pay the patients for a portion of the pills, according to court records. One patient told agents he received $20 for each deal.

Source: Jim Hannah, The Enquirer, [4/18/08]

Query: Recommended Work Boot

Would someone recommend a work boot that offers torsional rigidly, rigid sole support, leather uppers, and roomy toe box.

Frank DiPalma, DPM, Athens, GA

RE: Limb-Length Discrepancy in Biker (Steve Wolfington, DPM)
From: Stanley Beekman, DPM, Kevin A. Kirby, DPM

Assuming there is a structural leg length (which is extremely rare), the correct way to treat this is to first determine if the shortage is in the femur or the tibia. If the shortage is in the tibia, then the lift should be placed between the shoe and the pedal. If the shortage is in the femur, then the crank on that side should be shortened accordingly.

Stanley Beekman, DPM, Cleveland , OH

It would not make good biomechanical sense to correct for a limb-length discrepancy (LLD) in a cyclist by using crank arms of different lengths. As Dr. Hatfield noted, when different lengths of crank arms are used, the side with the longer crank arm will have a shorter saddle-to-pedal distance at the beginning of the power phase at top dead center of the bicycle pedal revolution but then, at bottom dead center of the pedal revolution, will have a longer saddle-to-pedal distance. This will produce undesired frontal plane rocking of the cyclist's pelvis on the saddle and will produce asymmetrical hip, knee and ankle mechanics which may, in fact, cause other problems and/or pathologies in the cyclist.

A more biomechanically sound method of allowing a cyclist to ride without having abnormal compensations for a short leg is to use a shim between the cleat and the sole of the cycling shoe. In Dr. Wolfington's patient with a 1.5 cm LLD, a 1.5 cm shim would likely decrease her low back pain with cycling. One commercially available wedge (about $25) is the "LeMond LeWedge" that allows for either varus or valgus wedging or for reverse stacking to compensate for LLD. I have also had more thrifty patients use stacks of full grain leather from old belts to accomplish the same type of cleat shims. A 1.5 cm shim will also require the cyclist to get longer screws to attach the cleat through the shim to the shoe sole.

The best way to evaluate for proper shim length is to watch the cyclist ride their bike on a stationary trainer. If proper shim length is achieved, their posterior superior iliac spines will be level with a minimum of frontal plane rocking.

Kevin A. Kirby, DPM, Sacramento, CA, kevinakirby@comcast.net

RE: Generating Reports from Lytec (Howard J. Bonenberger, DPM)
From: Hal Ornstein, DPM

I have been in touch with Darwin Tec and they are putting together clear instructions to run PVV for all their customers. I am also working to gather what doctors would feel to be most useful reports from a billing and practice management software. They will pay to have these reports programmed as a service to their Lytec customer and that is why we say their customer service is great They go above and beyond.

Hal Ornstein, DPM, AAPPM Chairman, Howell, NJ, toetoe@optonline.net

Podiatrists vs. Orthopods (Multiple Respondents)
From: Richard Gosnay, DPM

Editor's note: This extended-length letter can be read at: http://www.podiatrym.com/letters2.cfm?id=19088&start=1

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