Diabetic Foot Exam

As the population is advancing in age and Diabetes has become more prevelent, a vast amount of patients are presenting to my office for a Diabetic Foot Exam.

The purpose of the exam is to keep a patient's feet healthy and to keep the patient active for as long as possible.

The exam begins by evaluating the lower extremity skin texture, tone and coloration.

The pulses are evaluated to help determine if adequate blood flow is getting down to the feet.

The superficial nerves are evaluated as some Diabetic patients describe feelings of stinging, burning or throbbing pain, tingling or even a loss of sensation.

A thorough examination of the toenails, interspace of the toes and plantar feet is performed.

I also discuss diet, exercise and smoking cessation as applicable with my patients.

Stop by any of our 4 convenient Greater Seattle locations.
Let Integrative Foot and Ankle Centers take excellent care of your Diabetic Foot needs.

It's Summertime!! Time to Flip Flop or Not???

Flip Flops.

Patients often ask my opinion on flip flops. I love them, but they are awful for your feet. Let me tell you why:

Bacteria; one pair of flip flops can house 100's of thousands bacteria including Staphylococcus Aureus and fecal matter. (Ewwww)

They can cause a hammer toes and stress fractures due to gripping with the toes to keep the flip flops in place and repetitive trauma without shock absorption. They can also exacerbate bunions.

Blisters can form between the toes due to chronic rubbing of the plastic strap in the interspace

Been dealing with plantar fasciitis? Those flip flops could be making it worse by allowing the foot to repeatedly lift and drop onto the back of the shoe. Also without a supportive arch, you could be flattening the arch and causing the foot to over pronate (foot arch height drop and foot turn outward)

Flip flops are a staple of the Spring and Summer but make sure that you are making the best decision for your feet.

Hammertoes

A common condition that I see in my practice is hammertoes.

My patients ask where they come from. How did they get them? How can they fix them?

Hammertoes are bending of the toe at the joint. They may cause the toes to contract during standing or rest.

They are usually caused by a tendon or muscle imbalance which can stem from a neurological disorder. Hammertoes also have a genetic component or they can initiated by wearing tight shoes.

Stretching and massage of the toes can help to relieve pain associated with the deformity. Toe pads and wider shoes are also viable treatment options. Surgery can permanently correct the deformity but should be carefully considered and thoroughly discussed with your doctor.

Toenail Fungus

 

What is toenail fungus?  Toenail fungus is known as onychomycosis which can affect both the toenails and fingernails. The fungus may cause the nails to become thicker, discolored, disfigured or it may cause splitting. 

Thickened toenails can cause pain due to pressing against the inside of the shoes, leading to irritation, pressure and curvature of the toenails if they are not properly treated.  

 

Who gets toenail fungus? Toenail fungus can happen to almost anyone but it appears to be on the rise due to the increased diagnosis of Diabetes. Also aging, hygiene and a weakened immune system can play a factor.

 

How can it be treated? Fungus of the toenails can be treated in various ways

1. Topical antifungal. The medication is usually a cream or liquid and needs to be applied daily for several months to one year to see improvement

 

2. Oral antifungal medication: There are several oral medications on the market but before I prescribe any of these medications, the patient must get a liver function test to make sure that the liver is healthy enough to support the medicine.

 

3. Laser toenail treatment: Laser toenail therapy utilizes a heat laser.

 

4. Removal of the toenails

 

Will I be cured? At Integrative Foot and Ankle Centers of Washington, we will do a thorough evaluation to discover the best treatment option of you. Just as all feet are not the same, no one treatment is the same for every individual.

Also, we strive for excellence but none of the treatments may cure the fungus 100%

 

Are you sure that it's fungus? Some bacterial infections and changes of the toenails related to aging can mimic toenail fungus. A biopsy of the toenail may be performed in the office to discovery what  offending organism may be in the toenail.

 

 

Schedule your consultation today

 

 

 

 

 



 

 

 

 



Ankle Fracture

Ankle Fracture

A broken ankle is commonly known as a fracture. There may be one or more bones broken.
The ankle is made up of 3 bones: the tibia, the fibula, and the talus. The fractures can range in severity which can allow some people to remain walking on it whereas others may not be able to walk for months.

Patients usually describe a fall or a twisting injury to the ankle which causes pain, swelling, bruising and difficulty walking or inability to place pressure on the foot or ankle.

Ankle fractures may be evaluated by X-ray. But further imaging studies such as a CT scan, MRI or an arthrogram may be necessary to discern if there is some soft tissue damage to ankle ligaments or tendons.
Some fractures can be treated with either a cast or a CAM walker (walking boot) where some others need to be surgically repaired.

Ankle injuries are serious and can be debilitating if left untreated. Schedule an appointment at Integrative Foot and Ankle Centers of Washington for a prompt and thorough examination.

Orthotics

Orthotics 

What are they?

Orthotics are devices that can be applied to your shoes to provide structural or supportive changes.

Why do I need them?

Orthotics can be used for conditions such as flat foot, bunions, hammertoes, neuromas, amputations and heel spurs. They are also helpful for people who stand or walk frequently throughout the day.

What if I'm a Diabetic?

Orthotics can also be used to provide cushion and reduce pressure and friction in Diabetic patients.

Will they help if my feet hurt while working out?

Orthotics can be be useful to maximize your walking or running routine. 

How do I get a pair?

Come into the Renton office for an evaluation of what type of orthotics will be best for your individual needs.

Do you have a callus or a wart?

Many patients come into the office with painful lesions on the bottom of the foot. Some patients will have self diagnosed their condition and even begun a treatment regimen of topical creams, ointments, salves or even compound products (2 or more elements (medications) mixed into one).
Usually these products don't work or the patient is not seeing the results that they expect, so they appear in the office for a consultation.

Usually a scraping of the lesion with a scalpel blade is necessary to determine exactly what kind of lesion is on the foot. This scraping is usually not painful.
Different types of lesions:
Callus usually form in areas of pressure or friction. They usually appear yellow or gray.

Warts are viruses caused by Human Papilloma Virus (HPV). Warts have many different color variations such as gray, brown, or pink. Some have dark spots throughout or A single dark spot in the middle. Warts will not usually go away on their own if the immune system is weakened.

Treatment for calluses is usually shaving the lesion down and applying cream to soften them.

Treatment for warts usually consists of shaving down the lesion, freezing the lesion, applying Salicylic Acid and covering the lesion to prevent it from breathing. Laser therapy can even be performed.

My office can help you determine what lesion you may have and perform the appropriate treatment option. We also have a state of the art laser. Stop by for a consultation.