Tuesday, April 23, 2013

Getting Your Feet Healthy For the Summer

Here comes the warmer weather, causing many to kick off our shoes and socks and opt for flip flops or sandals. Perhaps though you have been ignoring your feet for the last several months and now need to get them in shape for flip flop and sandal weather. Here are some tips to get these feet fit for summer.

First, start with an at home pedicure. Soak your feet in a lukewarm water to soften the skin and nails. Remember, if you are diabetic, have someone else check the temperature of the water. Remove any dirt out from under your nails. Then cut your nails straight across to reduce the chance of creating ingrown toenails. Do not cut your cuticles. They help keep germs away from your skin and nails.
Next, examine the parts of your feet that experience the most friction (such as your heels, the sides of your feet and big toe) as they will feel the most callused. The easiest way to soften these rough patches is by first soaking your feet in warm water and exfoliating skin that is extra dry. After you towel your feet dry, use a pumice stone on the callused areas. If your feet are extra-callused, you may have to repeat this process for a few days to notice results. After you’re done, it is important to apply a lotion over the dry patches of your feet to allow your skin to re-absorb moisture. Watch out for over the counter corn/callus removers. These are medicated with salicylic acid which can eat away both good skin and callus which can cause open sores and ulcerations if used inappropriately. These should never be used on diabetics.

If you have noticed some thickening or color changes to your nails over the winter, you may have the start of a toenail fungal infection.  There are now topical anti-fungal medications that can be used as a base coat before using regular nail polish is applied, to help prevent and treat toenail fungus. Get it checked out by your local podiatrist.

With these simple tips you can whip your feet into shape for whatever the summer may bring.

Dr. "Sandie" Grulke

Tuesday, April 16, 2013

Marathon bombing brings out the best in Americans

It is hard to understand how yesterday's tragedy could have happened. Yet despite the horrifying scenes, you hear the good stories of people helping people. On the radio and TV we are forced to relive the terrifying scenes but now more and more stories of herioc events are being told. One such story is of a podiatrist who the Doctors at Podiatry Care Specialists all know, and the student doctors of his that assist at the finish line, all jumping in to help the wounded.

Dr. Palamarchuk, a podiatrist from Temple University School of Podiatric Medicine, has taken students to the Boston marathon for 28 years. A tent is set up for the end of the race for those runners suffering from foot and ankle issues to be treated. Most of the runners would be treated for simple blisters and ankle sprains. Not this year. They were located half a block from the explosion site. Dr. Palamarchuk and his students ran to the victims aid. They were able to triage patients. Taking the lead from the medical doctors in the area, they were able to treat some of the victims and move them out of the area. He was quoted in an article for NBC 10 to say "Everyone treated. It's just quick, grab whatever you can. They reacted quickly and took the lead of the medical doctors. It was a good effort. I was proud of them."
Dr. Palamarchuk

What should have been a exciting day turned into a horrifying events but yet these stories of good continue to prove the strength of the American people. As Fred Rogers stated "When I was a boy and I would see scary things in the news, my mother would say to me. Look for the helpers. You will always find people who are helping."


Sunday, April 14, 2013

Kobe Bryant Achilles Rupture

Kobe Bryant, from the suburbs of Philadelphia, has suffered a season and possibly career ending injury. While playing basketball, he ruptured his Achilles tendon. The Achilles tendon is the thickest and strongest tendon in the body.  A rupture is a devastating injury and can be a career ending injury for some. In basketball, Charles Barkley and Shaquille O'Neal both had Achilles tendon concerns and ended their careers early.  In baseball Ryan Howard suffered one, but he has been back to playing baseball full time.

To get back into activity, it can take anywhere from 9 months to a year for a full recovery. Kobe has already said that he is looking forward to returning and playing once he is healed from this. He will undoubtedly get a lot of physical therapy during his postoperative course.

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Monday, April 1, 2013

Kevin Ware Louisville Basketball Leg Injury

By now everyone has heard of Kevin Ware, the unfortunate basketball player who landed while trying to block a shot and fractured his tibia. It is not the play that has made the news but the type of injury that he sustained that has gotten such attention. His injury has been likened to the injury sustained by Joe Theismann, a career ending injury for the quarterback of the Washington Redskins. Both players sustained not only a fractured tibia but an open fracture which means the fractured bones have penetrated the skin and are exposed. How could this happen? What does this mean for Kevin Ware's future?

This injury was caused by the amount of weight placed on his tibia, the weight bearing bone of the lower leg, and then angle in which he was landing. The tibia snapped like a pencil causing the fracture to pierce through the skin. What can make these such concerning injuries are a number of things. First has the blood supply been disrupted at the level of the fracture? Second,  has there been nerve damage? Has the skin been compromised, will the skin be too damaged to repair and need skin grafts to heal over the bone? Lastly, with the bone exposed there is a concern of developing an infection. For all these reasons an open fracture is considered a surgical emergency. The blood supply and nerves must be evaluated and repaired if necessary. Antibiotics must be immediately started. The bone must be stabilized. The time to treatment is extremely important in these cases. "The Golden Hour" is the period of time after an injury is sustained that prompt medical treatment will result in the best outcomes from the injury.
Example of rod used in repair
For Kevin, immediate medical treatment allowed him to receive antibiotics to prevent infection. His doctors were able to set the fracture and place a long metal rod within the bone. His wounds were washed out and closed. He has a long road of recovery ahead of him but the prompt treatment he received will hopefully allow him back to the basketball court next year.

Dr. Alexandra 'Sandie" Grulke