Moisturize Those Winter Feet

Brrrrrrrrrr. It’s winter time in the Southeastern Pennsylvania area. The harshness of the cold temperatures and gusty winds that occur during December, January, February, and even part of March wreck havoc on the body. The hands and feet are particularly vulnerable as the extremities are the farthest parts of the body from the heart. We protect our body from the cold by wearing warmer and layered clothing. Gloves, hats, and scarves protect the most exposed parts and are important elements for protection, especially as we get older. Something we commonly overlook is moisturizing our hands and feet, especially our fingertips and heels. The back of the heel is especially vulnerable to scaling and cracking. A crack through the skin is called a fissure and can result in a foot infection as there now is a portal of entry for bacteria to enter the body and grow. Diabetics and vascular compromised people are most at risk.
Treatment-Prevention and maintenance of the integrity of the skin surface is done through regular use of skin moisturizing agents. There are many products on the market as many of them do an adequate job. Some leave a greasy film and some are tacky, so choose one that you are comfortable with. I prefer to recommend ones that leave a smooth finish and will penetrate easily without a large amount used. It doesn’t matter which one you choose as long as it is applied at least once and preferably twice per day, especially in the winter. A pumice stone or callus scraper can be utilized prior to moisturizing, but never use any sharp instruments like scissors or razor blades. Free edges of skin should not be pulled. If there are many layers that need to be treated, seek a podiatrist’s help and not a pedicure salon. This is a serious condition and should only be performed by a well-trained professional.

http://www.podiatrycarespecialists.com/

By Bradford J. Jacobs, DPM

Barefoot Running Part 2

We briefly mentioned last week about the potential hazards and dangers of barefoot running. I thought that I would just add a few more interesting things about it. A study published in The Journal of Sports Medicine and Physical Fitness said that barefoot runners had less impact than runners in shoes. On the flip side to this, there has been no documented studies that show running with sneakers can cause foot problems or lead you to an injury. But if you can think about some of the stuff that I had posted last wee I will not recommmend doing it.  This is because it can lead to stepping on something, lacerations, increase in pain, and blisters just to mention a few.

Happy Running/Walking, but of course with sneakers on :)
Chad J. Friedman, DPM
http://www.podiatrycarespecialists.com/

Barefoot Running

There has been a lot of talk in the literature recently on barefoot running. In fact there was even a book written on the topic (Born to Run). Its going to be something that many people will begin to try or continue to do. For me, I will not be recommending it. Some of the reasons for this is the risk of stepping on something, contusions, sprains, strains, and possible fractures. Depending on your foot type, the foot should be constantly supported through all phases of gait. If not, it can cause other muscles to compensate for other muscles and lead to tendon problems or other stresses in the feet. The feet need good support to support the rest of the body. Think about this as well; could you imagine running on a track, concrete, or gravel barefoot? Imagine this even on a hot sunny day. Your feet would burn and increase your chance of developing blisters. And of course this would never be good in a diabetic or someone who has developed neuropathy of their feet(loss of sensation). We will continue to update you on more information that will come out with the topic, but for the time being it is something that I will not recommend.


Happy Running/Walking, but of course with sneakers on :)
Chad J Friedman, DPM
http://www.podiatrycarespecialists.com/

Matt Ryan and Turf Toe from Exton, PA

Matt Ryan, the Atlanta Falcons QB, is from Exton, PA. He also went to William Penn Charter in Philadelphia, PA. He recently just suffered a condition known as Turf Toe. Turf Toe got its name from players commonly getting this condition while playing on artificial turf. Turf Toe can be better explained as a sprain of the big toe joint. This can happen as shown in the picture. When the foot is in a flexed position, this can sprain the big toe joint. Sometimes it can be severe enough where it actually can tear some of the ligaments of the big toe joint. This can lead to arthritis in the big toe joint and a bunion deformity.

Symptoms start out as swelling and pain in the big toe joint. Also with difficulty propulsing off the big toe joint. 

A good clinical history along with X-Rays and a possible MRI can help diagnosis the condition. It is usually treated with RICE; Rest, Ice, Compression, Elevation. Usually a taping to the big toe joint along with a stiff sole shoe to help prevent flexion of the joint allows the injury to heal. It can take up to a month and sometimes even longer for the injury to heal. And atheletes are unable to play during this time. Although it is rare, surgery may be an option if Turf Toe goes undiagnosed or if there is a rupture to the ligament.

http://www.podiatrycarespecialists.com/

Happy Thanksgiving

We would like to wish everyone a Happy Thanksgiving!! Please keep in mind if you are doing a lot of cooking or running around this holiday season to be in good supportive shoe gear and to avoid as much as possible going barefoot or just having socks on

http://www.podiatrycarespecialists.com/

Medicare Advantage and Medicare Supplemental Insurance

This is the time of year when many senior citizens have important health insurance decisions to make for upcoming year. With a change in health care reform on the horizon, many insurance companies have taken steps to protect themselves. This has included dropping certain plans from their options (in Pennsylvania- Keystone Complete will be eliminated) or raising premiums drastically. This has caused a great deal of concern as has been expressed to me and the other podiatrists at our Podiatry Care Specialists, P.C. offices.

Many insurance companies now offer Medicare Supplemental or Medicare Advantage programs. It is imperative that you do your homework on theses various plans.

Traditional Medicare will pay 80% of their approved amount to physicians that accept assignment. The remaining 20% must be paid by the subscriber or will usually be paid by enrolling in a Medicare Supplemental Plan. Many insurance companies participate in this and Medicare Advantage plans such as Humana, Cigna, United Health Care, Aetna, and the various Blue Shield organizations.

What does Medicare Advantage mean? The following has been taken from Wikipedia:

With the passage of the Balanced Budget Act of 1997, Medicare beneficiaries were given the option to receive their Medicare benefits through private health insurance plans, instead of through the original Medicare plan (Parts A and B). These programs were known as "Medicare+Choice" or "Part C" plans. Pursuant to the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, "Medicare+Choice" plans were made more attractive to Medicare beneficiaries by the addition of prescription drug coverage and became known as "Medicare Advantage" (MA) plans.Traditional or 'fee-for-service' Medicare has a standard benefit package that covers medically necessary care members can receive from nearly any hospital or doctor in the country. For people who choose to enroll in a Medicare Advantage health plan, Medicare pays the private health plan a capitated rate, or a set amount, every month for each member. Members typically also pay a monthly premium in addition to the Medicare Part B premium to cover items not covered by traditional Medicare (Parts A & B), such as prescription drugs, dental care, vision care and gym or health club memberships.[10] In exchange for these extra benefits, enrollees may be limited on the providers they can receive services from without paying extra. Typically, the plans have a 'network' of providers that patients can use. Going outside that network may require permission or extra fees.Medicare Advantage plans are required to offer coverage that meets or exceeds the standards set by the original Medicare program, but they do not have to cover every benefit in the same way. If a plan chooses to pay less than Medicare for some benefits, like skilled nursing facility care, the savings may be passed along to consumers by offering lower copayments for doctor visits. Medicare Advantage plans use a portion of the payments they receive from the government for each enrollee to offer supplemental benefits. Some plans limit their members’ annual out-of-pocket spending on medical care, providing insurance against catastrophic costs over $5,000, for example. Many plans offer dental coverage, vision coverage and other services not covered by Medicare Parts A or B, which makes them a good value for the health care dollar, if you want to use the provider included in the plan's network or 'panel' of providers.

You must make sure you compare apples with apples for all these options. The following should be checked:
1- Your primary care physician is a participator of the plan
2- Your main specialists are also participants
3- Make a list of your medications and see what these plans cover each generic or trade name prescription you take and what the copays are
4- Do they require 90 day prescriptions
5- Is there a deductable for Doctors Visits, Hospitalizations, and Emergencies
6- Is there a maximum out-of-pocket expense for theses services
7- Cost

Hopefully this information will help you explore your options and get the best health care possible for your needs at a reasonable cost.

Yours for better health,
Bradford J. Jacobs, DPM

http://www.podiatrycarespecialists.com

Lecture

Dr Chad Friedman recently gave a lecture at St Albans Church in Newtown Square. The lecture was presented to St Anastasia's members. The lecture presented was on general foot health and included bunion, hammertoes, neuromas, heel pain, arthritis, fractures, diabetes, and wound care. For more information please visit out site for educational videos

http://www.podiatrycarespecialists.com/