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 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!

 

Pascal Dupuis

Most of the people that read my blog know I love to watch ice hockey, and also know that I especially like the Pittsburgh Penguins.  Today, the Penguins announced that winger Pascal Dupuis has a a "blot clot in his lung."  This is more specifically a pulmonary embolism.   A few months ago, I blogged about how American Idol contestant, Michael Johns, lost his life due to a pulmonary embolism.

The Penguins say that Pascal had chest pain and was evaluated and the embolism was found.  He apparently had a blood clot in his leg (DVT = deep vein thrombosis) that traveled to his lungs.  A DVT in the leg is, in and of itself, not the problem.  However, it can cause very painful leg swelling and inflammation.  The problem is if that blood clot breaks away and travels to the lungs it can be deadly.  Most people would go to the ER if they had trouble breathing, but people need to take sudden painful swelling in the leg just as seriously.  Immobilization after injury, as well as being seated for long periods of time (eg, a long airplane trip), can be a couple of the common causes.

Pascal will be unable to play hockey for at least 6 months as he will need to be on anti-coagulants, or blood thinners, for at least that time to prevent further clots.  As most of you know, hockey is a contact sport and blunt trauma and blood thinners are not a good combination.

The Penguins say that Pascal should be able to return to hockey.  Unfortunately, however, this is his second blood clot.  One has to wonder if he would want to risk coming off anti-coagulation as he is obviously prone to developing thrombi in this body.  I guess time will tell, but either way, he will have to closely watch for developing symptoms for the rest of his life.

Let's Play Hockey!

For a hockey fan like myself it is the greatest time of the year.  (OK, so maybe second greatest if your team makes the playoffs).  The season officially begins tonight and tomorrow my favorite team, the Penguins, and the local team, the Lightning, begin the season.  Because of this occasion, I feel it is appropriate to post my previous hockey blogs.

http://donaldjadamovdpm.blogspot.com/2013/06/alex-ovechkins-broken-foot.html

http://donaldjadamovdpm.blogspot.com/2013/03/kris-letangs-broken-toe.html

http://donaldjadamovdpm.blogspot.com/2013/02/erik-karlssons-achilles-laceration.html

http://donaldjadamovdpm.blogspot.com/2013/01/ice-hockey-is-back.html

http://donaldjadamovdpm.blogspot.com/2011/11/ice-hockey-and-foot-injuries.html

Tom Hanks Makes an Announcement

Earlier this week, on late night TV, Tom Hanks announced that he has been diagnosed with diabetes.  He talked about lifestyle changes he needed to make and also a little about how the disease effects the body.  I have had a few patients over the years that presented with foot problems that lead me to suspect that he or she could be a diabetic.  The patient usually knew something wasn't quite right but was completely unaware that this disease was present.

One of the earliest signs of diabetes in terms of the foot would be numbness or tingling.  Diabetes is a disease of high blood sugar and this high blood sugar can cause several problems with the body.  Diabetic neuropathy is caused when nerve fibers are damaged by the high blood sugar.  This can be uncomfortable as a bothersome numbness in the feet but also can lead to pain.  Besides the discomfort, this loss of feeling can but a patient at risk for injury.  For example, a stone in the shoe can cause a sore.  A person without diabetic neuropathy would remove his or her shoe and remove the stone, but a diabetic patient may not even know that there is a stone in his or her shoe.  Left in the shoe the stone can lead to a sore or ulceration.

If you think you have diabetes you should see a physician for testing.  Symptoms are not just tingling in the feet but also weight loss, increased thirst, and increased urination.

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.

This is NOT recommended

Just when I thought I had seen it all, I read this story online from "Runner's World": Keith Levasseur ran Saturday's Baltimore Marathon in 2:46:58 while wearing flip flops.  Apparently, he performed the stunt for the Guinness Book of World Records.  Looking closely at the picture, they are some of the more supportive flip flops, but still I find this to be insane.  To top it all off, he finished 39th out of over 3000 runners.

Flip flops are a popular shoe all over the country, and here in Florida they can be worn essentially all year.  However, these shoes are not created to walk in for long distances or even wear long-term.  Historically, they are to protect feet to get to the beach from your car over hot pavement or to prevent you from picking up a wart or athlete's foot in a public shower or pool.

These shoes can lead to all sorts of problems such as heel pain and also provide no protection for the top of the foot or the end of the toes.  I have seen several painful toenail injuries from the wearing of these shoes.

I know I will not make many people give up their flip flops but I recommend them only for limited periods of time and certainly prefer my patients wear ones with an arch in the sole.  Our shoe store and all of our offices have available sandals and flip flops that are better for you feet than the "traditional" flip flop.

Kobe Bryant's "Mild Foot Discomfort"

I admit that I am not a huge basketball fan, but I do keep an eye on the sports headlines.  Being a podiatrist, a recent headline caught my attention.  It turns out that yesterday Kobe Bryant missed both LA Laker practices with "mild foot discomfort."  I am sure one of the greatest basketball players of all time will be closely evaluated but anyone can take note of this headline.  Foot pain is not normal!  If Kobe Bryant would have tried to "work through it" he could have made the condition much worse.  I can not tell you how many times I see a patient who waited several months or even a year with significant foot pain.  This patient is much harder to treat as the condition has often worsened.  As with most things the sooner you deal with an issue, the easier it is to resolve.  Moral of the story: foot pain is not normal and we should take it seriously.

What shoes should you wear?

Being a Disney lover, I still have to "pinch myself" that I can go to the parks on a very regular basis.  Recently on the "Disney Parks Blog," the following video of "feet at EPCOT" was posted.  Most non-podiatrists do not notice people's shoes but I find this interesting.  Most of the feet are covered in sneakers but I also saw several flip flops.  Everyone is different, but typically I find you can never go wrong with a supportive sneaker while active.  If you are going to wear a sandal, I recommended one with an arch.  These can be more difficult to find, but are available.  In fact, we have several in our office.  Foot pain is never normal and I pride myself at keeping my patients on their feet so they can do whatever activity they like including walking around all the great theme parks we have here in Central Florida.

Arriving in Florida for a different reason

There have been many trips to Florida in the past.  The I-95 Florida Welcome Center was always one that was looked forward to.  It always meant a fun adventure was awaiting me and my family.  Last week, however, the welcome center was "welcoming" one of Florida's newest residents.  I am very excited to become a Floridian and look forward to contributing to my new community both as a citizen and a podiatric physician.