The Voice of Podiatrists

Serving Over 11,000 Podiatrists Daily

April 30, 2009 #3,533 Publisher-Barry Block, DPM, JD

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CO Podiatrist Removes Decade Old Toothpick From Patient's Foot

After a dozen years, a Colorado State University student who unknowingly had a toothpick lodged in her foot is free of the object. Jasmine Rainey said she heard over and over growing up the story of how she had stepped on a toothpick that was sticking up on her kitchen floor. The doctor had told Rainey and her mother that he thought he had fully removed the wood after the accident. More than a decade went by before Rainey felt something she described as strange.

Dr. Chrystal Berg

Rainey went to Denver Health Medical Center to have her foot operated on. There, podiatric surgeon Dr. Chrystal Berg thought she would be removing a common cyst. "After I removed the mass, when I was taking it to go to be sent to pathology, that was when the toothpick made its appearance," Berg said.  Nearly the entire toothpick that Rainey had stepped on as a child emerged. "It literally just slid out," Berg said.

Berg says she routinely removes things like glass and nails from people's feet. But the toothpick in Rainey's foot was different.  "It was unusual -- she stepped on it as a small child -- and her foot grew with the toothpick inside of it and it didn't break or dissolve and it didn't cause her any problems for many years," she said.

Source: Mike Hooker, KCNC-TV CBS 4 Denver (CO) [4/27/09]

MA Podiatrist Re-Elected to RUC

Lloyd S. Smith, DPM was recently re-elected to a second two-year term as a The RVS Update Committee (RUC) Panel Member. He is the only podiatrist ever to serve in this osition. The RUC is a representative body of healthcare professionals and physicians that petitions the Medicare program to determine the annual fee schedule update for all medical and surgical services. It is managed by the American Medical Association.

Dr. Lloyd Smith

Dr. Smith, in his RUC panel role, is a representative of the American Podiatric Medical Association and the non-MD/DO organizations that can bill the Medicare program for their services. His term will end in May, 2011. Smith is in private practice in Newton, MA and is a past-president of the APMA.

Query: Nocturnal Leg Cramps

Nocturnal leg cramps are a common problem. I used to prescribe quinine but it is no longer available. Has anyone found anything that works for this vexing problem?

Richard Mann, DPM, Delray Beach, FL
 

Query: APMA and Red Flag Rules

Has the APMA given us any specific guidelines that might help us write our own individual rules. I have a limited idea about what I need to do but I don't have the time or the expertise to provide details. Can someone email me their rules and I'll modify them for my own practice!

Bruce Krell, DPM, Chandler, AZ
 

Editor’s note: APMA members can click here for this information. PM will have further information in our June/July 09 issue.

RE: Ingrown Nails in 3 Month Old
From: Multiple Respondents

I had a 2 month old with a similar condition. First, I did a complete avulsion. 

Ingrown Nail with overlapping skin in infant

Three months later, I ended-up having to do a partial excision.

Roger Friedman, DPM,  Elyria, OH, Roger@RogerFriedman.com

I treated a case like this once, 15 years ago. The case looked just like this.The baby had the distal phalangeal tuft growing dorsally. We had to take the baby to surgery to decrease the bone, (fishmouth incision distal hallux and trimmed the bone) and the baby was fine.

Johanna Youner, DPM, New York, NY, JYouner@nyc.rr.com

I would treat this child by permanent nail procedures in the OR or surgery center done under supervision with the anesthesiologist, just as our ENT colleagues do myringotomies. As you've noted, this patient would not sit still for a photograph. They cannot be expected to sit still for a procedure. I have had no problems with pediatricians, anesthesiologists and more importantly, parents understanding the need for this procedure to be done in this fashion.

Once a patient is sedated, anesthetizing the toe(s) and doing the procedure does not take any length of time. The only material I have provided on these occasions are applicators small enough for these toes. I usually ask the parents to provide socks for the child and put them on over the small bandage in the OR, before the patient is revived. 

James Judge, DPM, Wake Forest, NC, jjandleah@kindnblue.com

RE: Acroangiodermatitis (Pseudo Kaposi's).  in Compromised Patient (Stephen Bennett, DPM)
From: Bryan C. Markinson, DPM

Depending on how symptomatic the patient is, the only chance at cure is decreasing venous hypertension. Since edema control did not help, an investigation for an underlying venous malformation or A-V fistula, and surgical resolution thereof, can be curative. In the absence of these, symptom relief is the best you can do. I would discourage debridement of these lesions. I would get a vascular consultation with an effort to communicate to the vascular physician exactly what it is you are looking for. It is a good bet that due to her age and medical history, they may hesitate to do any "open" surgery, but that may be something for the interventionist to consider.

Bryan C. Markinson, DPM, New York, NY, bryan.markinson@mountsinai.org

RE:  Fundraiser for the Leukemia and Lymphoma Society
 
About a year ago, PM News included a notice about my recovery from non-Hodgkin's lymphoma and my fundraising efforts for LLS.  I was running for their Man of the Year competition in the Chicago area, and was able to raise about $23,000 during the 10-week competition. Since then, I was able to recover fully and purchase a practice from a retiring podiatrist in Chicago, and start practicing again after a very tough four years. As anyone who has had to battle cancer mid career can tell you, the hassles of running a practice are a welcome problem after that fight. Thank you to all who supported me.
 
This year, I suggested to my Universal/Schein rep that he participate in the event this year, as he had worked with LLS through his fraternity in college.  He  is now 7 weeks into this year's 10-week competition with about 15 other Chicagoans. Patrick asked me if PM News could run another notice, as many of PM News readers are customers of his, and might want to support him.   Anyone who wants to support Patrick in this wonderful cause can contribute online at this link. 
 
Richard C. Bennett, DPM, Chicago, IL, rcbpod@aol.com

RE: The Amazing Feet of Jessica Cox
 
The amazing thing is that if you ask this remarkable young woman what she thought about her disability, she would probably look at you as though she had no idea what you were talking about.
 
Neil A Burrell, DPM  Beaumont, TX, nburrell@gt.rr.com

ASSOCIATE POSITION - CENTRAL VIRGINIA

Join a solo surgeon in a two office private practice, modern facilities with EMR and digital x-ray, reconstructive and trauma surgery.  Excellent starting salary and benefits. Position leads to partnership. Submit letter of introduction and CV to jdisabato@vfasa.com

PRACTICE FOR SALE - FLORIDA—CENTRAL/SOUTH

Turn-key operation grossing $570,000 annually based on one full-time doctor. Great opportunity for growing the top-line. Surgery is only 14% of the professional man-hours; it can significantly increase income. Medicare makes up 64% of revenues. Seller will assist with transition. Call 863-688-1725, ask for Chas.

ASSOCIATE POSITION - CHICAGO AREA

Join one of the most successful, long-established podiatry practices in the Chicago area, with excellent salary and benefits. We have an immediate opening for a full-time podiatrist in a multi practice location in Chicago. Must have two years of surgical residency. Please e-mail resume to f-massuda@footexperts.com

ASSOCIATE POSITION – ILLINOIS 
 
Quality Podiatry Group provides quality services to residents at long term care facilities. We are currently offering full-time or part-time positions for motivated ethical podiatrists. Immediate openings available. If interested, fax curriculum vitae to 312 225-9366 or e-mail feetwork@aol.com

EQUIPMENT FOR SALE

MIN-x-ray Mobile system Model PM200R40. Brand new less than 1 year old. never used at all. I was opening a new location that fell through. Completely brand new. paid $11,000 Will sell for $8,500. Located in the Bronx, NY- call 914-714-0667.

ASSOCIATE POSITION - CONNECTICUT

Nice community outside of New Haven. Well-established, busy practice seeking part-time or full-time associate. Excellent opportunity for a highly motivated and ethical professional. Must have good patient skills. PSR-12 or higher with excellent skills required. Send resume and cover letter to fax # 203-439-7916.

ASSOCIATE WANTED - FLORIDA

Associate needed for a dynamic multi-doctor practice in the Tampa Bay area. Partnership opportunity for the right candidate. Preference given to a PSR 24+ resident completing their education this spring/summer, and must have a Florida license. Well-established practice, high tech with EMR and digital x-rays, with specialties in sports medicine, surgery and wound care. No nursing homes or HMO's. Excellent hospital privileges available. Choose an area of practice concentration that you are passionate about and enjoy a lifestyle for yourself and your family that is second to none. E-mail: kimvelez@tampabay.rr.com

OFFICE SPACE/ MRI RENTAL – NYC, LI   
 
Turn-key space available, daily, monthly; East 60th off Park Ave, East 22nd St. off 3rd Ave, and Plainview Long Island. JACHO-certified operating rooms available, as well as all surgical equipment and anesthesia. Extremity MRI Rental. Stark compliant. All exams read by board certified radiologist. Call for details. 516 476-1815

NEEDED CHICAGO -- NW IND & BALTIMORE/WASHINGTON, DC PODIATRISTS

Home Physicians, a medical group specializing in house calls is looking to hire podiatrists in Chicago, Northwest Indiana, and Baltimore, MD. Full and part-time positions are available. Competitive Compensation including malpractice. Contact Scott Schneider. Phone-773-342-4201 FAX 773-486-3548-E-Mail sschneider@homephysicians.com Visit our website

ASSOCIATE POSITION AVAILABLE-MIDTOWN MANHATTAN

Looking for Full-time associate to work in well established practices in midtown Manhattan and Forest Hills. Immediate opening for PSR 24-36 surgically trained Podiatrist. Great opportunity with competitive salary along with malpractice benefits. Please send CV to slurie@papapc.net

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