July 17, 2006 #2,632 Editor-Barry Block, DPM, JD

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Patients Often Confuse Fungal Infections With Dry Feet: OH Podiatrist

Dr. Jeffrey Oster is a podiatrist and medical director of www.myfootshop.com a consumer oriented web site for foot and ankle problems. "Patients are surprised to find out that what they’ve considered to be dry skin is actually a treatable form of fungus. These are patients who have tried countless skin softeners and have not found success in softening their skin. As a result, they’ve given up and say ‘nothing ever works for my dry skin.’ "

Treating chronic fungal infections of the foot requires a commitment to follow through with regular treatment. Dr. Oster recommends the following:

1. Rotate your shoes, allowing them to dry for 48 hours between use.
2. Wear socks and change them twice daily to wick moisture away from the skin.
3. Use a topical antiperspirant to dry the bottom of the feet.
4. Apply a topical OTC tea tree oil based antifungal medication to the feet daily.
5. Daily use of an antifungal shoe spray to disinfect your shoes.

Dr. Oster stated, "It’s important that patients realize that fungal foot infections can’t be treated with one tube of medicine. Success requires a plan and ongoing daily treatment."

Source: PR Web [7/14/06]

OH Podiatrist Returns From Abu Ghraib, Iraq With Bronze Star

Dr. Brad Wenstrup with Service Medals

U.S. Army Reserve Major Brad Wenstrup sees his experiences in Iraq as being about freedom. Now, having returned from 11 months and 18 days as chief of surgery at Abu Ghraib prison in Iraq, he said freedom was what he didn't have. But for him, the situation there is more about the freedom of the Iraqi people.

"They are fighting for their freedom over there," he said after his return. "You know, George Washington had a miserable time his first year, but he persevered. That's what the Iraqis are doing. They are persevering and they are succeeding." Wenstrup, 48, Mount Lookout, is a podiatrist with Wellington Orthopaedics in Blue Ash and Anderson Township and returns to his practice after time relaxing and vacationing with friends and family.

Wenstrup's mission was to medically treat the prisoners at the prison, as well as treat any casualties, American or otherwise. Wenstrup said he treated everything from the complications of diabetes, to podiatric problems brought on by the 50-pound packs carried by soldiers, to amputations. He also treated the up to 5,000 detainees. "I think some of them wanted to be captured to get the medical treatment" he said. "This is the stuff you don't hear about. ... they called us 'Angels of Mercy.'"

Source: Liz Carey, Community Press [7/14/06]

MT Board Revokes License of Convicted Podiatrist

The Montana State Board of Medical Examiners has revoke the medical license of a Missoula podiatrist. Bart Holt was arrested in an F-B-I sting, while trying to lure an underage girl over the Internet for sex. The board revoked Holt's license for five years or until he completes his prison term, whichever is longer. Holt's tentative sentencing date is September 21st.

Holt was arrested last year when he showed up in Billings, for a rendezvous with what he thought was a 13-year-old girl with whom he had been having sexual conversations over the Internet. The other person was, in fact, an undercover federal agent.

Forty-seven-year-old Holt pleaded guilty last month to coercion and enticement of a minor, and possession of child pornography. Holt agreed to forfeit two computers, a Web camera, a cell phone and a vehicle used in committing the crimes.

Source: Associated Press [7/14/06]

Query: Patients Who Steal Supplies

I have a 12 yr old Medicaid patient with mental health issues. He is a surgery patient, awaiting an arch reconstruction following a successful surgery on the opposite side. Someone, likely his mother, has taken all of the various sized Band-aids and ointment out of the treatment room on two separate occasions. While I don't have video proof of this, it was noticed immediately after they left by office staff. Do I confront the mother?

Name Withheld (MD)

RE: Podiatrist Charged With Sexual Assault (Richard Boone)
From: Andrew I. Levy, DPM

I have always had a policy of having a female assistant in the room with me whenever I am doing any exam or procedure which requires a closed door, or palpation of upper level structures, such as femoral pulses or nodes. In fact, I think the same proprieties need to be observed when dealing with female employees.

Andrew I. Levy, DPM, Palm Beach Gardens, FL

AndrewLevyDPM@aol.com

RE: Orthoses Research Study (Craig Payne)
From: Eric Teeman, DPM

Craig Payne was right, I hadn’t read the entire article when I made my comment, and I apologize. He encouraged me to go to the library and look it over, so please let me share:

This study completely misses the boat, for several reasons:

1. The Sham orthoses, which serve as the baseline, are 6 mm. thick and “designed to provide minimal structural support.” Why —a true sham should provide no support at all.

2. There is no mention of compliance—no knowledge which subjects used their devices where and for how long each day.

Nothing personal, but the presumption that Dr. Landorf (the investigator) and the orthotic laboratory accurately represent the casting and manufacturing standards of our profession is hopeful at best. Apparently, all “customized” orthoses were posted identically. Furthermore, 23% of the subjects had broken protocol by the 12-month follow-up, substantially reducing the sample size for the long-term evaluation.

Most importantly, while these researchers pat themselves on the back for reducing so much bias, they share conclusions with the general population which effectively create bias about the real-world benefits of custom orthotic devices. We in practice have seen thousands of patients with plantar fasciitis. We have seen prefabs help in some cases, and when accurately-fabricated, seen custom devices do what prefabs could not.

Our exclusive knowledge and ability to provide custom orthoses is an important source of income, and if they had put some more thought into their groundbreaking study, we wouldn’t have to work harder to convince somebody that “Dr. Scholl” can only do so much.

Eric Teeman, DPM, Tampa, FL, eteeman@tampabay.rr.com

Editor's note: This topic is now temporaily closed

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