The Voice of Podiatrists

Serving Over 13,500 Podiatrists Daily

August 23, 2012 #4,547 Publisher-Barry Block, DPM, JD

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Good Foot Health Starts with Good Hygiene: CO Podiatrist

Let’s get to the bottom of things — specifically, to your feet. You need them and they need you. After carrying you everywhere, every day, don’t they deserve some TLC? Sure they do — but they don’t always get it. “Good foot hygiene and nail care are ignored by a lot of people,” said Dr. Angelo Giarratano, a Pueblo podiatrist with more than 30 years of experience.

Dr. Angelo Giarratano

Giarratano doesn’t see people unless they already have a problem with their feet. He said three basic things can do a great deal to keep people from becoming patients: washing, cutting toenails properly, and wearing supportive shoes. “Bathe (feet) every day and change socks every day,” he said. “Nails should be cut straight across, not angled.

Source: Amy Matthew, The Pueblo Chieftain [8/20/12]

NYCPM Students and Residents Display 15 Posters at APMA Scientific Meeting

NYCPM students, residents, and faculty co-authors presented 15 research posters at the recent APMA Annual Scientific Meeting in Washington, DC.

Arthritic Foot Pain? See a Podiatrist: APMA President

Our feet change with age. Because of this, the steps we take to keep them healthy have to adjust accordingly. “While staying active is a great way to preserve overall health and can positively impact foot health, aging can naturally increase the risk of certain foot ailments,” said Joseph Caporusso, DPM, a podiatrist and president of the American Podiatric Medical Association.

Dr. Joseph Caporusso

“It’s important to know the symptoms of age-related foot ailments and take steps to minimize their impact on your overall health.” The causes of arthritis can range from heredity to injuries to bacterial or viral infections that affect the joints. Arthritis may take several forms, so if you’re experiencing foot pain it’s best to have it diagnosed by a podiatrist.

Source: Manitowoc Herald Times  [8/21/12]

VA Podiatrist's Surgery Transforms Zambian Teen's Life

Those who know 18-year-old Anderson Mambwe say in the past several months, he has been transformed. The soft-spoken, lanky, and now tall teenager from Zambia came to the United States in March for surgery on his feet, which are deformed because of a congenital birth defect that went unchecked in Africa. For years, Anderson has suffered excruciating pain just to walk on his large, misshapen feet. The only treatment in Zambia was amputation. He was meek and small -- until now.

Dr. Charles Zelen

"He was passive. He was quiet. He was scared," said local podiatrist Dr. Charles Zelen, who is helping to treat Anderson. "And now he's revealing self-confidence and respect for himself. Rather than being so fearful and scared, his personality is coming out. His enthusiasm is now coming out. He's now proud." Zelen performed the first of two surgeries to repair Anderson's feet in April, and the procedure hasn't just changed his walk, but his personality.

Source: Annie McCallum, The Roanoke Times [8/21/12] 

UK Podiatrist Joins Healthcare Firm

LONDON 2012 has certainly whet the appetite for sporting endeavours, and a Grimsby healthcare business is ensuring it can hit the ground running with a new recruit. The Achilles Centre, in Dudley Street, has taken on recently qualified podiatrist Claire Feetam.

Claire Feetam

"We have always had a client base with the elderly, and people with diabetes, but people taking up running may realize they have a problem with their foot, feet, or in the lower limbs. It could be the Achilles, it could be the calf; we cater for lots of different things," said Geoff Allen, the Center's manager.

Source: This is Scunthorpe [8/21/12]

Attendees Experience Glorious Greenbrier Coding & Practice Management Workshop

Amid the splendor of the magnificient historic Greenbrier Resort nestled in the West Virginia mountains, over 50 attendees enjoyed both the informative morning lectures, the afternoon recreation activities, and the elegant dining experiences this unique venue provides. 

Attendees at Greenbrier Coding and Practice Management Workshop

Workshop speakers included Drs. Brad Bakotic, Barry Block, Michael Brody, Harry Goldsmith, John Guiliana, Jonathan Moore, and Josh White, along with AAPPM speakers Rem Jackson and Chad Schwarz. 

Query: Treating a Diabetic with an Inversion Sprain

My patient is a 55 year old NIDDM male with peripheral neuropathy who presented last week with inversion sprain history from the previous day. There was marked edema about the ankle and midfoot, primarily over the dorsal lateral midfoot, and ecchymosis to the lateral aspect of the heel near the load-bearing margin. There was no erythema or limitations with passive or active range of motion. All tendons appear to be intact. There is no apparent laxity with the drawer test. X-rays of foot and ankle demonstrate no apparent joint distraction or disruption, and no fractures were noted.

I treated this as if it were a Charcot foot waiting to happen - with a fracture walker and compression for 48 hours until the edema reduced enough to apply a cast. He is in a weight-bearing cast now for almost a week, and will progress back to the fracture walker for 3-4 more weeks. Does anyone view that as being overly cautious?

Philip McKinney, DPM, Eugene, OR

RE: 25,000 Hours
From: Hal Ornstein, DPM

Recently, I sent Barry Block a message about how much I love the Podiatry Management Hall of Fame Luncheon at the APMA National Meeting and seeing so many caring, loving, and dedicated individuals for the good of our profession in one place. I thought it would be neat  to add up how many hours everyone has given collectively to grow our awesome profession.

I was curious and asked Barry how many hours he has put into PM News since its inception and was simply amazed with his answer. In the past 18 years, he estimates that he has spent 25,000 hours putting out over 4,500 issues of this daily publication. This equates to three solid years of his life! This is such a reflection of the giant Barry is for our profession and how many lives he has touched and changed. I am so proud to call him a friend. From us all… Thank you Barry.

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

RE: Terminating an Office Manager (Name Withheld)
From: Fay Mushlin

It would be helpful to have more information. You describe your office manager as doing a "good job", but you are looking for "excellence." I think that your description of the difference between the two is important. What was she/he hired to do? Was that employee trained for that position?

What are your expectations of that position, and what is it that you think is not being fulfilled? Further information is needed in order to give realistic suggestions, recommendations, and a solution to your office situation. The AAPPM has an executive managers track which may be of some benefit for your office manager.
 
Fay Mushlin, Newtown Square, PA, teegee46@gmail.com

RE: Terminating an Office Manager (Name Withheld)
From: Dale Rosenblum, DPM

A burnt out or bad employee is a real liability. Thinking that I could not live without my manager, I kept her way too long. Bad signs are when they want to be part of your family and want to take work home, or don’t want to take time off when you are there. My advice is to pay her and walk her out that day. No notice is necessary. Be sure you are well documented for the wrongful termination suit she will then file.

Dale Rosenblum, DPM, Fullerton, CA, drosenblum@linkline.com

RE: Microphone for Dragon Med 11 (David Kahan, DPM)
From: Adnan Shariff, DPM

I have used both headsets and hand-held microphones. Although you pay much for a handset such as the one you mention, it is much more convenient when using EMR. You just pick it up, hold the record the button, and speak. The headset obviously requires you to put it on and take it off each time. I find it much easier with the hand-held.

I have used the Phillips Speechmike and the Speechmike Air. I like the wireless because I can go to the x-ray developer, dictate the x-ray report, and when I go back to the computer, it's already dictated in the field. I have used knowbrainer.com for research and buy my gear from talktoyourcomputer.com, and have them install everything.
 
Adnan Shariff, DPM, Okeechobee, FL, drs@floridafootspecialist.com

RE: Two Tests for Posterior Tibial Dysfunction
From: Terrance J. Mueller, DPM

While I am delighted that Drs. Haggerty and Grattolino are helping to spread the word about the diagnosis of tibialis posterior dysfunction (the official term, as per the ACFAS "Preferred Practice Guidelines" for dysfunctional flatfoot), the "too many toes" sign and the "heel raise test" are imprecise, and came from the non-podiatric medical literature years after the proper/definitive evaluation of the tibialis posterior tendon and muscle unit were described in the podiatric literature.
 
The purest function of the TP muscle/tendon is adduction; no other muscle/tendon unit does...

Editor's note: Dr. Mueller's extended-length letter can be read here.

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