Kelly Ripa's Broken Foot

Yesterday Kelly Ripa came out to host her morning show with a walking boot on her left foot.  It turns out that the day before she "stepped wrong" on a weight left on the floor during her dance class.  She later found out that she broke multiple bones in her foot after hearing a "bubble wrap" sound.  She is told that she does not need surgery but will require 6 weeks of immobilization in the boot.  I am not sure whether or not she was joking but she says for her it will be "more like 3."

As a podiatrist who treats foot fractures, I find this interesting.  Fractures anywhere in the body take at least 6 weeks to heal.  So she is not going to cut down her time to 3 weeks unless she wants to have a non-healing fracture or even further damage that may require surgery.

I also found interesting her choice of a shoe for the other foot.  (Apparently she was advised to wear an appropriate shoe on the other foot and refused according to her discussion on her show). One does want to balance a walking boot with a shoe of equal height on the other foot, but she is not weight bearing yet.  She is wearing a fairly high heel on her right foot and I certainly worry about a foot or ankle injury on the right limb as well.

The National

Since Orlando is only a couple hours away, I was excited to see that the National Scientific Seminar of the American Podiatric Medical Association was to be held in Orlando this year.  I decided that I would attend my first national conference and just returned home to Spring Hill.  Podiatrists from all over the country came to Orlando this past weekend.  I must say I was very impressed with the conference.  I have, of course, attended many conferences more regional in the past, but this one was so much bigger.

In addition to well respected speakers, the exhibit hall was great.  I have again found products and services to make the practice and care I provide to my patients even better.  I am eager to get to the office Monday morning and get to work!

A Personal Milestone

I am the type of person who does my best to avoid bragging.  I really do not have an ego and consider myself a fairly humble guy.  However, I am also a person who has been blessed with many experiences throughout my life and enjoy reflecting on my life.  July 2015, specifically July 10, 2015, marks the completion of 10 years in private practice.

I hope readers of this blog will bear with me as I have a little fun and look back on these 10 years:

Indianapolis:
July 11, 2005 - August 2008

As a doctor fresh out of residency, this was a time to grow in my career.  Medical school and residency does not do a lot to prepare someone for private practice and I learned a great deal during my 3 years here.  Indianapolis is a wonderful city and my wife and I will certainly treasure our time here.

Pittsburgh:
September 2008 - October 2011

I specifically lived and worked a little south of the city in the West Mifflin area.  (About 6 miles south of downtown).  Growing up in NE Ohio (and a Cleveland sports fan), I was not raised to love Pittsburgh, but it is a unique and beautiful city.  With me being from Akron, and my wife being from Dubois, PA, this put us exactly in between and 100 miles away from each of our hometowns.  In Pittsburgh, I learned a lot about caring for patients in the hospital setting and wound care.  These are certainly valuable skills.  The surgeries I performed here completed my requirements for board certification which I achieved during the end of my time here.

Winter Haven (Polk County), Florida:
November 2011 - April 2013

You can see from the Pittsburgh picture that snow was always part of my winters.  I was thrilled to move to "Winter Haven" and haven't seen snow since.  I would say that my experience here was concentrated on "practice management."  Having learned the medicine part pretty well, this allowed me to focus on learning how to run a practice.  More than just billing and coding, but also providing valuable services that give patients great outcomes.

Spring Hill, Florida (Absolute Healthcare, LLC):

April 2013 - April 2015

Coming to Spring Hill and working with a multi-specialty group was invaluable.  I have a great deal of respect for Dr. Gaurav Malhotra.  Working with an MD helped me figure out where I fit in with the medical team to care for patients.  Having only worked with podiatrists in the past I missed different viewpoints.  Medicine is changing, the primary physician is going to direct care in the future to cut down costs and focus on prevention.  Though no one really knows exactly where we are headed with all of this, my time here allowed me to better determine my role in patient care within the medical team.

Spring Hill, Florida (Donald J. Adamov, DPM, PA):

May 2015 - Present

Never would have I imagined, as a young doctor going into work for the 1st time on July 11, 2005 in Indianapolis, that 10 years later I would be practicing in my own practice 1000 miles south in Florida.  I moved around a lot in those 10 years, but the experience I gained has been so important in the forming of the philosophy of the care I provide my patients.  I appreciate the trust that my patients have placed in me.  I never take the responsibility of caring for my patients lightly.



A Very Exciting Annoucement

Many of you may be aware that in December of 2014 I began transitioning from being an employed podiatrist at Absolute Healthcare to becoming a solo practitioner.  Late last year, Donald J. Adamov, DPM, PA was formed.  I decided that after close to 10 years in private practice, it was time to "give it a try" on my own.  I figured that I would be able to care for patients the best way I know how and could make my own decisions when it comes to the services I offer my patients.

This is why, I am so excited to announce, that effective Monday, May 4th, I will begin practicing at my new location:

1250 Mariner Blvd.
Spring Hill, Florida 34609
352-606-3950

The new office is just over 2 miles south of the old location at 3376 Mariner Blvd.  It is just south of the YMCA on the same side of the road.  Our office is in the plaza directly behind Susie's Grill.  We have purchased brand new comfortable treatment chairs as well as a state-of-the-art digital x-ray machine.  This machine will allow us to diagnose fractures and other bone problems during your visit.  We are also looking into offering more items to help treat our patients such as arch supports and other medical equipment.

The new office is in addition to adding an additional morning to see patients at the Spring Hill wound care center.  Now in addition to Thursday afternoon, I will be seeing patients Wednesday morning as well.  If you have a wound you can always see us at the Mariner office, and if appropriate, I can then follow-up with you at the wound center.

I look forward to seeing you at the new location!

 

New Office Renovation

People are hard at work completing the final touches on the new podiatry building on the campus of Absolute Healthcare.  I am very pleased with the new spacious office.  I find it very welcoming and am excited to start caring for my patients in this beautiful building.

My Weekend in San Antonio

This past weekend, I traveled to San Antonio, Texas for a wound care course.  Though I have visited Texas while in middle school, I have never been to San Antonio.  I enjoyed seeing the city including staying on the Riverwalk and visiting the Alamo.  However, my primary purpose for the trip was a 12 hour wound care course.

As a podiatrist, part of what we do is caring for diabetic foot ulcerations.  So, I have been doing wound care for over 10 years.  The 3 years I spent in Pittsburgh was heavy on surgical limb salvage of diabetic feet.  During my time in Winter Haven, I also was on staff at the wound center in Lake Wales, Florida.

I really think I could make a difference in this community of Hernando County in regards to wound care.  Therefore, I have been working closely with the Spring Hill Wound Care Center and the experts at this facility recommended this course.

Though I am experienced, I still learned quite a bit at the course and am eager to begin using these new ideas to help people here in this area.

5 things people do wrong for their feet

I was recently talking to a close colleague who is an internal medicine physician.  As people who read my blog know, I like to blog about sports injuries and celebrity foot problems.  However, this doctor was interested to know what I believe are the most common things people do wrong with regards to caring (or often times, not caring) for their feet.  I thought about it, and in my 10+ years of experience I had an answer, I thanked my colleague for the question and immediately answered it.  I think this information is worth sharing.

5 THINGS PEOPLE DO WRONG FOR THEIR FEET:

1) Ignore foot pain:  Many patients think that pain in their feet will just go away.  It could, but odds are it will get worse if not treated.  For example, heel pain can affect how you walk as a patient can often compensate by walking differently due to the pain.  Walking differently can lead to tendon pain in the other ankle or in a different part of the painful foot.  Additionally, pain in the foot or ankle is often inflammatory in nature.  Inflammation that is allowed to worsen can often be much more difficult to resolve than when treated earlier.

2) Going barefoot:  Especially down south, many people do not like to wear shoes.  However, this can have significant consequences.  Of course, there is always a chance of injury without the protection of footwear.  Cuts and scrapes can be especially harmful to a patient with poor circulation or feeling in his or her feet.  Additionally, when one goes barefoot there is no support.  This can lead to tendonitis as tendons work to support a foot that a shoe should be supporting.  I often hear, "going barefoot is natural."  I counter this argument by replying "what is natural about concrete?"  You do best in a man-made supportive shoe when walking on this man-made surface.

3) Wearing flip-flops:  In Florida, these shoes are a year round favorite.  In other parts of the country, they come out when the snow thaws.  However, these shoes, especially the really flat flimsy ones, are just as bad as going barefoot.  They offer little support or protection for the foot.  It is hard, as people love these shoes, but at least try to get one with a rigid sole and even an arch.  A small heeled wedge sandal is much better than a flimsy flip-flop.  However, a trip to Disney World is probably best enjoyed in a sneaker.

4) Using medicated pads or callus remover:  I am fine with padding that can be bought in the drug store, as this can be a good conservative treatment for some foot problems.  However, any padding that says "medicated" can be very harmful.  Medicated pads usually contain salicylic acid.  Yes, real acid that damages skin.  The acid can not select the "good" tissue from the "bad" callused tissue and I have seen infections from using these products.  Unfortunately, in a few diabetic patients, I have seen the use of these pads lead to bone infection and toe amputation.  A callus is more than just something that can be removed easily as there is often an underlying deformity leading to this hardened uncomfortable skin.

5) Doing "bathroom surgery":  We likely have all done this.  A toe can be a little sore and we "dig out" a toenail in our bathroom using a dirty pair of toenail clippers or whatever object available.  This can lead to a bacterial infection needing antibiotics.  Again, as with medicated padding, I have seen bathroom surgery lead to amputation.

This is my list of 5 things people do wrong for their feet.  Podiatrists are trained to treat almost all foot or ankle problems.  I welcome new patients who are experiencing any foot or ankle pain.

Kobe Bryant's Scar

There has been a lot of talk recently regarding Kobe Bryant's quick recovery from his achilles tendon surgical repair.  Not to down-play this recovery, but being a physician who has performed several achilles tendon repairs, I noticed something about this scar.  When looking at it, I notice that it is obviously healed well, but I also notice that the scar stops further up on the ankle.  To me, this means that he likely didn't require a more complex repair that often involves some detachment of the tendon from the heel bone.  In this case, the repair, though still very successful, has a much longer recovery time.  This is because hardware is often used to reattach the achilles tendon to the heel.  In this case, the patient must partake in a much more gradual return to activity, especially to perform at the high level needed to play in the NBA.

If you have any achilles tendon problems, keep in mind that it is important to address them and not wait.  Patients who wait have a much higher chance of needing surgical correction.

Something to Celebrate

As a podiatrist, I read with interest a recent study that shows a drastic increase in lower extremity diabetic amputations.  The study was published in this month's Foot and Ankle International.  The study pointed out when looking at Medicare claims from 2000-2010, lower extremity amputations decreased 28.8%.  I am wondering if this is related to the 143.3% increase in the treatment of foot ulcers in the same time period.  Also interesting is that amputations at the upper and lower leg level are down 47% while partial toe amputations increased 24%.  (Sometimes a toe amputation is needed to be done by a physician like myself to prevent the infection from getting worse).  To me this means podiatrists are saving feet and legs.

This is a big deal on many levels.  First, it saves money.  Lower extremity amputations cost our health care system a lot of money.  Second, it improves patients quality of life.  Obviously, having a limb amputation is a big deal and can lead to other problems.  Earlier studies have found that a lower extremity amputation has a mortality rate of 50% within 5 years.  So one can argue that saving some one's limb, saves some one's life.

I am proud to have a hand in all of this and excited to continue to help bring down the level of amputations in my community.

Alex Ovechkin's Broken Foot

As I have said before, I am a Penguins fan so I am biased to say Sidney Crosby is the best player in the world.  However, last evening, the Washington Capital's captain beat Sidney Crosby out by winning the Hart Trophy as the NHL's MVP.

As a podiatrist, I was also interested to learn that Ovechkin played a few playoff games and for Team Russia with a broken left foot.  Surprisingly he admitted not telling doctors about it until after the season.  It is thought that he sustained a "hairline fracture" blocking a shot in the Capitals / Rangers playoff series.

This, in my opinion, is unwise as a hairline fracture or "stress fracture" can become a "full fracture" and lead to a break in the bone that can heal in a poor position or not well.  Sometimes surgery, especially in a pro athlere, is then needed.

Usually stress fractures cause swelling in the foot and pain especially after being on the foot for awhile.  I have seen countless stress fractures that are not visible on x-ray but very evident on MRI.  Therefore, just because one recieves a normal x-ray reading does not mean nothing is wrong.  Any foot pain, especially with severe swelling, should not be overlooked.