drbarrykatzman

BUNIONS

Dr Barry Katzman, Podiatrist Queens — Wed, 25 Jan 2012 17:00:44 +0000

What is a Bunion? Bunions are often described as a bump on the side of the big toe that develops as the first metatarsal shifts medially and the big toe shifts laterally towards the second toe. This misalignment of the bones and joints result from faulty inherited mechanical structure and function of the foot that causes the foot to compensate in the development of the bunion. This is a progressive disorder that worsens as time goes on if not addressed and may be aggravated by certain shoe types. Treatment may consist of padding, injections, anti-inflammatory medications, change in shoe gear, orthotics or surgery. Orthotics while not a cure, can eliminate or reduce many of the weaknesses and imbalances of the foot that are causing the bunion to grow and as a result, slow down the progression of the deformity to the point where pain and arthritic changes can be avoided and bunion surgery may not be necessary, especially if orthotic therapy is started early. As surgery corrects the deformity but not the cause, I will routinely have orthotics made for my patients to prevent the bunion from growing back.

Ankle sprains

Dr Barry Katzman, Podiatrist Queens — Sat, 21 Jan 2012 20:28:22 +0000

One of the most common injuries seen in my office are lateral ankle sprains. What is an ankle sprain? Sprains are injuries of ligaments which are bands of fibrous tissue that connect bones to support and strengthen joints. When an injury occurs where a joint is forced to go beyond its normal range of motion, the ligaments are often injured. Sprain injuries are categorized by grades 1-3 (grade 1 being the least severe and grade 3 being the most severe) with grade 1 being a strain (damaged but not torn) , grade 2 a partial tear and grade 3 a complete tear or rupture of the ligament. These can be serious injuries. If they are not immediately treated properly, the ligaments can heal in a stretched position leaving the joint unstable and more prone to future injury. If you suffer this injury, you should seek immediate medical treatment which usually involves x-rays, immobilization of the joint, anti-inflammatory medications and crutches for more severe sprains. If you are unable to get immediate attention, apply ice to the injured area for 20 minute intervals, apply compression to prevent swelling and remain off the foot until x-rays can determine the full extent of the injury.

DIABETIC NEUROPATHY

Dr Barry Katzman, Podiatrist Queens — Wed, 14 Dec 2011 16:47:21 +0000

Tingling, numbness, pain or a squeezing sensation in the extremities ( arms, legs, hands, or feet )— these are all common signs of diabetic neuropathy, or nerve damage. Nerve damage can also occur with no symptoms at all. Up to 70 percent of people with diabetes will develop some type of neuropathy, making it one of the most common side effects of this disease.

PROTECT YOUR FEET because decreased sensation or numbness is a common side effect of diabetic neuropathy, it is common to injure your feet and not be aware of it. This can often lead to serious complications or amputation of the feet and legs as one can develop a serious infection or ulcer that won’t heal due to the diabetes. This risk increases as you age or the longer you have diabetes, so it is extremely important to inspect your feet daily. (See my blog for diabetic foot care ).

Keeping your diabetes under control and taking your medications is the best defense for keeping diabetic neuropathy minimized.

TREATMENTS vary and have mixed results as the many medications for diabetic neuropathy often have side effects so the best course is one of prevention as much as possible by keeping your diabetes well controlled and getting regular medical and podiatric check ups.

SECOND OPINIONS

Dr Barry Katzman, Podiatrist Queens — Wed, 23 Nov 2011 04:52:40 +0000

Many times a patient may feel intimidated or afraid of hurting their doctors feelings when contemplating getting a second opinion. No one is perfect or infallible. If you have a good understanding doctor that is secure in their abilities, they should encourage you to obtain a second opinion or even a third opinion. A second opinion can be obtained by the patient seeking another physicians opinion or by having your own doctor review your records with one of their peers. Second opinions can be very helpful, this is especially true if you are not seeing the results you think you should be or are uncomfortable with either the diagnosis or treatment plan. If your doctor gets insulted or chastises you for your wishes it may be time to find another doctor.

FOOT WARTS

Dr Barry Katzman, Podiatrist Queens — Sun, 30 Oct 2011 20:49:08 +0000

There are many different types of warts ( verrucae ) but all are caused by viruses ( human papilloma viruses ). There are flat warts that are seen on the hands, knees, face and neck. Verrucae vulgaris are seen on the hands and knees. Genital warts are a growing problem and are sexually transmitted. When it comes to the foot there are 2 main types of verrucae. They can be found on the top or plantar surface of the foot. There are verrucae plantaris that grow on the bottom of the foot. They can grow as isolated lesions or as a few single isolated warts distributed throughout the foot. A more invasive and harder to treat wart are mosaic verrucae. As their name infers, they grow in mosaic like patches. These foot warts are very aggressive. They grow and spread quickly and can takeover the entire surface of the plantar skin on the foot if not treated in a timely factor.

Commonly mistaken for calluses or corns they frequently go untreated until they become painful or spread. They can be contagious. As no one form of treatment will work equally well for all types of warts, there are many different types of treatments that are utilized to rid these painful unsightly lesions from the skin. The most common treatment methods are different types of acids topically applied ona daily or weekly basis, electro-dessication where the warts are literally electrocuted to death, lasers, cryotherapy which involves freezing them and surgically excising them. Unfortunately, as the viruses that cause warts continue to live in the body, there is no one sure treatment method which will guarantee that these lesions do not come back.

Symptoms of Diabetes

Dr Barry Katzman, Podiatrist Queens — Fri, 21 Oct 2011 22:25:30 +0000

It has been estimated that between 30-50 % of all patients with diabetes are undiagnosed. Considering the great physical toll diabetes takes on the human body ( peripheral nerve damage, vision problems, kidney failure, heart disease, loss of limbs ) one can understand just how important it is that this disease is diagnosed and treated as quickly as possible. Many people exhibit the signs and symptoms of diabetes but do not go for treatment as they do not recognize the symptoms as signs of having diabetes. As they are unaware that they have a problem the disease goes untreated. So this blog is dedicated to recognizing some of the more common signs and symptoms of diabetes. Here is a compilation of many of the most common symptoms of diabetes. If you have any of these symptoms you should see your medical doctor as soon as possible. Diabetes can be diagnosed with a simple blood test.

Excessive thirst
Frequent urination
Unexplained weight loss
Blurred vision
Tingling/numbness/burning in the hand, legs and feet
Extreme fatigue
extreme hunger
Frequent or recurring infections
cuts and bruises that take long periods of time to heal
Dry itchy skin
Fruit like breath

Orthotics as preventative care

Dr Barry Katzman, Podiatrist Queens — Sun, 02 Oct 2011 01:44:26 +0000

Many people know that orthotics are a great tool to help treat many foot pathologies such as heel spurs, plantar fasciitis and painful flat feet as well as alleviate pressure from painful bony prominences or callouses. What most people don’t know is that the use of orthotics can help prevent orthopedic deformities from occurring or significantly slow down their progression. Many foot pathologies such as bunions have a high degree of hereditary influences. But just because your parents had bunions or hammertoes doesn’t mean that you are doomed to the same painful foot problems. While your foot type and how they function may be hereditary, intervention to prevent such problems from developing can be a reality. A good functional orthotic when made properly, can address most underlying weaknesses and imbalances of the feet that would normally lead to orthopedic deformities. By addressing these weaknesses and imbalances, the destructive forces that would normally be at work when you walk can be eliminated or decreased so that even if the deformities do occur, they would occur later in life and the deformities would be of less severity. By properly supporting your joints there will be less stretching of your ligaments as the years go by thereby improving joint alignment and decreasing wear and tear on your cartilage which can lead to arthritis.

Avoiding sports injuries for the weekend warrior

Dr Barry Katzman, Podiatrist Queens — Fri, 16 Sep 2011 02:55:00 +0000

Now that the weather is starting to cool down its more important than ever to make sure you warm up properly before beginning an athletic endeavor. Whatever sport or athletic event you are doing, it is important to make sure you spend enough time warming up your core as well as targeting any muscle groups that may be doing most of the work. This can usually be done by starting with a brisk walk for a few minutes and then gently going through any sport specific motions that you will be performing. Once you start sweating you can add some light stretches and you are ready to go. To help reduce or avoid muscle stiffness and soreness the next day spend a few minutes stretching your large muscle groups such as your back, hamstrings and quadraceps immediately after you are finished. If you were engaging in a racquet sport a good stretch targeting your shoulder and arm muscles will also help.

SOFT CORNS / CORNS BETWEEN TOES

Dr Barry Katzman, Podiatrist Queens — Fri, 26 Aug 2011 02:32:08 +0000

A very common problem seen in our office are corns between toes. Soft corns, also known as helloma molle, form after irritation between 2 toes. The corn is usually whitish but can appear yellow and has a spongy texture. Soft corns are moist because they absorb excessive skin sweat trapped between the toes. Pain is usually the major symptom, but if neglected the skin and underlying bone may eventually become infected. Due to women’s shoe styles of high heels and narrow pointy shoes this problem is seen more often in women but men can be effected as well.

After proper diagnosis, a treatment plan is established to control the pain, reduce the corn in size and in many cases permanent surgical removable is available. The lesion is most often found between the 4th and 5th toes but can be found between any toes. Usually the bone in 2 adjacent toes rub against one another and the area of skin on the toe that is between those bones develops a corn in response to the pressure. With continued pressure it grows in size and increases in pain making wearing closed shoes very difficult. Often the patient develops ”kissing corns” where the adjacent toes develop corns overlying the bony prominences and touch when in shoes.

Treatment can be palliative or surgical. When treating it conservatively, the corns are shaved down and a small soft dispersion pad is placed around the corns to prevent them from rubbing against each other. This can be done every few weeks or months depending on how quickly the pain comes back. If a permanent solution is sought, surgical correction can be achieved in the office, surgical center or a hospital on an outpatient basis. The toes involved are anesthetized with a local anesthesia and the bones involved are shaved down so that the two adjacent bones won’t rub against each other when in a closed shoe. A few stitches are used to close the incisions and a small bandage is applied. The patient usually returns back to shoes in a few weeks with very little interruption of normal activities.

FUNGUS TOENAIL INFECTION

Dr Barry Katzman, Podiatrist Queens — Wed, 17 Aug 2011 20:13:53 +0000

FUNGUS TOE NAIL INFECTIONS

Are your toenails deformed, thickened, brittle, black, brown, yellow or green or white ? Do you have a build up of dead tissue under your toenails? If so, you may have a fungal toenail infection. This common disease, or onychomycosis, is an infection of the toenail and tissue under the surface of toenails (nail bed). It is usually caused by a fungi called dermatophytes or can be caused by a yeast infection as well. Once these infections take hold, they will not resolve on their own. These organisms like moist, damp environments and feed off the keratin protein which forms nails.

These toenails may develop a foul odor and are often extremely difficult to cut. They often become ingrown and develop secondary bacterial infections. The smell, difficulty in cutting, pain in or out of shoe gear or their unsightly appearance often lead to people seeking professional care.

Although anyone is capable of developing this infection, it is more common in people with diabetes, immuno-suppressed patients or very active or athletic patients as the trauma to the toenail gives this opportunistic organism a chance to take hold.

Fungal foot infections can be spread. Onychomycosis should be treated to avoid spreading. Fungal toenail infections can usually be treated by a number of different methods. There are topical medications that are very safe but have a lower cure rate. Oral medications have a better success rate but you will need blood tests to avoid side effects. Laser treatment is also an option for treatment but usually isn’t covered by health insurance.