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.

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.



Kyrie Irving's Sprained Foot

I am not typically a basketball fan.  In fact, it is probably on the bottom of my list of major professional sports.  However, after my first week at my new office, I am taking some time just to relax.  After all, this is the 1st weekend in a while on which I did not have to go work at the office preparing it to see patients.

As many of you know, I spent the 1st 29 years of my life in Northeastern Ohio.  I was born in Akron and my undergraduate degree is from The University of Akron.  I went to podiatry school in Cleveland and did my residency in the greater Cleveland area.

So, even though I am not a huge basketball fan, I pay attention when a team in Cleveland is doing well.  I do not think it is fair to call me fair-weather as I have been to plenty of Browns, Indians, Cavs, and minor league hockey games in downtown Cleveland and even in Richfield at the old Coliseum when these teams were not doing well.  I also really appreciate LeBron James returning to our hometown to try to bring the people of Northeastern Ohio a championship.

Therefore, I admit I have been following the Cavs.  Unfortunately, with Kevin Love's season being over, I am concerned with Kyrie Irving.  Reports say he has a foot sprain and he is playing with a limp.  As a podiatrist, I wonder if there is more than a sprain.  I start to think about a stress fracture.  After all, a painful foot and limping is not normal.  Often, when someone keeps walking on a sore foot or ankle, it can make the condition worse and harder to treat.

I just hope that Kyrie's injury does not worsen as he and Lebron compliment each other well and would not want any long term problems.

As I type this at the end of the 3rd quarter of game 4 vs. the Bulls, things certainly do not look good for the Cavs.  However, in sports anything can happen.

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!

 

Way to go, Scouts!

I was quite interested in the recent story that Ann Curry was hiking in New York and was "rescued" by a group of boy scouts.  There are two reasons for this interest.  First, as is the topic of this blog, I am a podiatrist treating conditions of the foot and ankle.  The second reason is something not everyone may know about me; I was a boy scout.  In fact, I am an Eagle Scout.

I remember learning how to splint ankles and my first aid training but never had to put it into action like these young men.  I found it even more of a feel good story that most of these guys didn't even know that they were helping a celebrity.  Kudos to these young men!

Charcot Neuroarthropathy

A recent article just came out that shows there is an increase in the occurrence of "charcot foot."  This condition usually affects diabetic patients who have decreased sensation or "neuropathy."  The process is not completely understood, but essentially the foot starts breaking in the midfoot.  What are supposed to be hard bones can become like mush.  The condition is self limiting and eventually the bone destruction stops.  The bones then will heal.  The problem is not the process causing damage it is when the patient walks on this foot that is breaking.  It can deform the foot and the bones can heal leaving a "rocker bottom" foot that is difficult to walk on.  This can cause sores, or "ulcers."  These ulcers can become infected and patients can have to have an eventual amputation from the problems this condition can cause.

The key to treating "charcot foot" is prevention.  A diabetic patient that usually doesn't have foot pain should be seen as soon as possible as this could be the early start of the condition.  The condition is often misdiagnosed as an infection or gout as the foot can become red and swollen mimicking these conditions.

If caught early, strict immobilization is imperative.  If caught after the deformity has already lead to disfigurement of the foot, wounds often develop and special braces and offloading shoes are needed.  This often becomes a wound care center issue.

I am not writing this to scare people but instead educate them.  This condition is rare but is becoming more common as I am seeing in my practice.  The take home message is to go see your podiatrist as soon as possible if you have any foot pain, especially if you are a diabetic.

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.

Two Years in Florida!

Those that know me, know that I like milestones.  I have been blessed to have the chance to experience many wonderful things in my life.  So, today is meaningful to me as I started practicing in Florida 2 years ago today.  Though it has taken some unexpected turns, I have enjoyed my time here and look forward to many more years as a northerner living in the sunshine state.

I think it is a good time to blog about my life and education.  This can be "my bio" as I have not really posted it on my blog yet.

The majority of my life was spend in Northeastern Ohio.  I was born in Akron and spent my entire childhood in Uniontown, Ohio.  A small town between Akron and Canton.  Growing up I always wanted to be a "surgeon."  I enjoyed activities at church, with scouting (I am an Eagle Scout), and playing the saxophone in band.

I graduated from Lake High School in Uniontown and my undergraduate degree is from the University of Akron.  My podiatry degree is from the Ohio College of Podiatric Medicine which is now the Kent State University College of Podiatric Medicine.  (This is interesting for an Akron grad).

I completed 3 years of training in podiatric medicine and surgery in the greater Cleveland area.  My training was affiliated with satellite hospitals of University Hospitals and The Cleveland Clinic as well as the podiatry school.  It was a well rounded program with lots of "hands on training."  On a personal level I married my wife, Heidi, during my second year of residency.

Upon graduation of residency, Heidi and I moved to Indianapolis where I started my career in private practice.  We enjoyed living there.  It had a smaller town feel with a lot to do.  I think some of the best restaurants are in Indy.  Living there over 3 years, we enjoyed all the city had to offer with the sports and auto racing to the culture.

In the fall of 2008 I decided to advance my career and Heidi and I also wanted to move closer to our hometowns and families.  Therefore, we moved to Pittsburgh.  This was 100 miles from my hometown and 100 miles from Heidi's hometown of DuBois, PA.  This was weird for a Browns fan from Ohio to live 6 miles south of downtown, but I fell in love with the Penguins as many know and also enjoyed following the Pirates.  However, sorry Steeler fans, never quite got into them.

The most significant event of our 3 years in Pittsburgh was the birth of our son.  Soon after that a job opportunity came up in Winter Haven and our family moved south.  We enjoyed our time in Winter Haven but transitioned to Spring Hill last April.

As one can see, I have lived in several places.  Great experiences for sure.  However, I certainly wouldn't mind settling here in Spring Hill, Florida and I am very excited as we continue to grow both professionally and as a family as we are expecting a baby girl next month!

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.

Exciting Annoucement

I am very excited to announce that effective April 24, 2013 I will be joining a new practice.  I will be the first podiatrist in a multi-specialty practice in Spring Hill, Florida.  I think my 8 years of experience will allow me to incorporate great podiatric care into this new practice.  I am thankful for the opportunity and am thrilled to continue to practice in the State of Florida.  Here is the information on the location with contact information:

ABSOLUTE HEALTHCARE LLC
3378 MARINER BLVD
SPRING HILL, FL 34608
352-678-3033