Although some of you may immediately get pictures of the Grey’s Anatomy cast performing surgery in the middle of an unsanitary bathroom, bathroom surgery is actually a term we like to use for patients performing their own care for foot ailments such as corns, callouses, warts and ingrown nails using sharp implements like clippers and razors. Many people feel that this is the way to take care of these problems. In fact, the federal government has stated that the routine treatment of corns and callous and the trimming of nails is within the realm of self-care; except for those with serious medical conditions that affect the circulation or sensation of the feet, like Diabetes. 

I must state that I disagree with this position. Routine trimming of normal toenails is by all means OK, provided the person has the flexibility to reach the toes and the eyesight to see what they are doing. I have seen many serious complications though when people try to self-treat in growing nails, warts, corns and callouses using sharp implements or chemicals. These conditions are best treated by a skilled foot specialist. In the state of New York, even pedicurists are not permitted to treat these conditions with sharp instruments. So what to do?

            A visit to a local podiatrist is the place to start. Not only can the podiatrist treat these problems easily and painlessly, we can determine the cause of the problem and find long term solutions so that bathroom surgery won't be necessary any more. Be sure to look for someone who is Board Certified, like the doctors at Midtown Podiatry, with locations in Midtown, Gramercy, Union Square, Wall Street and Glen Cove. Our Mission: To get foot surgery out of the bathroom and into the hands of our specialists!  Should you or a love one be suffering from a foot problem, drop the razor and pick up the phone and call us! You will be glad you did!

By: Dr. Paul Betschart

HOW TO PREPARE FOR FOOT SURGERY

Now that you and your doctor have decided on surgery as the treatment for your condition, there are some things you can do to get yourself ready for a comfortable and quick recovery.

Get your mind ready: It has been shown that attitude can effect the outcome of medical care and the perception of pain. Have confidence in the course of treatment and your doctor. If you are unsure, get a second opinion before proceeding. Learn some relaxation techniques such as deep breathing or meditation. Know that pain is expected after surgery. Relaxation techniques have been shown to reduce the need for pain medication. Have a positive attitude and focus on the intended outcome of the surgery. After the recovery, you will be glad of your choice.

Get your body ready: Proper nutrition is essential for recovery following surgery. If your diet is not the best, consider consulting a nutritionist for dietary advice. Supplements to consider include calcium and vitamin D for bone health, vitamin C and zinc for skin and soft tissue and extra protein for muscle support are good starting points. Hydration is important. Be sure to drink plenty of water. Be aware that some post-operative medications can cause stomach upset or constipation. Make sure you take the medication as prescribed and eat and drink normally. Extra fiber should reduce the incidence of constipation. Should antibiotics be prescribed, a pro-biotic vitamin can reduce the incidence of diarrhea. Yogurt or Kefir can be used as an alternative. If you will need to be on crutches post-operatively, make sure your arms and non-operative leg are strong enough to support you. Simple arm and leg strengthening exercises should be performed to get you ready. You can consider a consultation with a physical therapist or personal trainer to help get you ready for crutch walking.

Get your life ready: Your mobility will be temporarily restricted after surgery. Make sure you take care of chores prior to the surgery. You will want to do as little as possible in the first few days after surgery.

Make sure you have what you need on hand, including food, water and post-operative medications. Consider having a friend or family member stay with you to help out.

Get your house ready: Much like child proofing, you will want to fall proof your house or apartment, especially if you are going to be on crutches. Take a look around for things that can impede walking or trip you up, such as furniture, rugs, cables, etc. You may not want to use stairs right away, so temporary one level living should be considered in homes with stairs. Make sure the bathroom is accessible. Some accessories that can make toileting and showering easier are: a commode that can be used as a toilet riser, a shower seat, suction grab bars and a cast/ bandage cover to keep the operated foot dry.

These items can be obtained at a surgical supply store or through catalogs. Some items may be covered by health insurance as well. Make the kitchen accessible as well. Make sure frequently used items are easily within reach. Consider preparing meals in advance for easy microwaving. Using disposable dinnerware temporarily will reduce clean up. If you will be on crutches, take a dry run around the house. You may be surprised at obstacles that you never thought of. You may want to consider crutch alternatives such as a knee walker or scooter if crutch walking is difficult for you.

Get ready to go: Depending on where your surgery is taking place, you may be required to have pre-operative testing and a medical exam done prior to the surgery. Make sure these are done at least 1 week before the surgery. Follow up with your doctors offices to make sure that the facility has all the results ahead of time. Follow pre-operative instructions to the letter. If you are having anesthesia other than local alone, make sure you don't have anything to eat or drink within 8 hours before surgery. You should continue to take prescribed medications unless otherwise directed by your doctor. Plan to arrive at the surgical facility in advance. Most hospitals and surgical centers require their patients to arrive 2 hours prior to their scheduled procedure time to allow for intake. For office procedures, 15 minutes is sufficient. Arrange for transportation home in advance. An escort is required for discharge by hospitals and surgical centers and is recommended for office surgery. Don't forget to arrange for transportation to your post-operative visits as well. Don't hesitate to call your doctor for any reason post-operatively. We are all here to make sure your recovery is safe and rapid.

If you have any questions prior to surgery, call the doctors of Midtown Podiatry.

Its time to say goodbye to 2011 and say hello to 2012! As the New Year rolls in there are many things to get excited about for this upcoming year; the year of the Dragon according to the Chinese, the 46^thSuperbowl, the Presidental Election of the United States and the return of the Olympics! With the Olympics in mind, a particular Gold medalist has been bringing light to a disorder that is frequently looked over. Peggy Flemming, who won the Gold Medal in 1968, has a passion for spreading awareness about PAD, a disorder commonly seen in our office at Midtown Podiatry.

What is PAD?

Peripheral Arterial Disease or PAD is a disorder of the blood circulation of the extremities where the blood flow is decreased. This is usually caused by narrowing of the arteries by a buildup on their interior wall called plaque. This condition resembles clogged pipes in your home. If the pipe is partially blocked, flow is decreased. If the pipe is completely blocked, flow stops. We don't want our blood flow to stop!

How do I know if I have PAD?

Some symptoms of PAD are foot and leg cramps while walking, coldness of the toes, loss of toe hair, nail irregularity and redness when the feet are down. Late signs are rest pain, non healing wounds and gangrene. PAD is easy to identify by one of the podiatrists at Midtown Podiatry. A physical examination will reveal clues and a simple, non-invasive test can give a picture of circulatory health in minutes.

What can be done about PAD?

In the early stages, exercise is the most common recommendation. Exercise increases the overall blood flow to the extremities and can cause blood vessels to form around the blocked area. Smoking cessation is a must if you are a smoker. Nicotine causes blood vessels to constrict, making them even more narrow. Medications which improve the flexibility of the red blood cells have also been shown to decrease symptoms of PAD. In later stages, intervention by a Vascular Specialist may be needed. Recently there have been many recent advances in the surgical management of PAD. Most exiting has been the endovascular removal of those plaques. Endovascular means working inside the blood vessel. It is a minimally invasive technique that can be performed with minimal or no hospital stay.

Should you or a loved one be concerned about PAD, make an appointment online today at Midtown Podiatry, with locations in Midtown, Gramercy, Union Square, Wall Street and Glen Cove immediately for a circulatory screening. We are offering it free of charge to all our patients and to anyone that you know!

*PAD can be a marker for circulatory problems in other parts of the body as well, like kidneys, heart and brain. This test could be a real life saver!

By: Paul J Betschart, DPM

Most New Yorkers can’t get on a subway without reading some kind of healthcare advertisement; and yet somehow so many people are unaware of exactly what a podiatrist is. Our podiatrists at Midtown Podiatry came up with a few facts that will answer some of your questions!

1. Podiatrists must be educated. It’s true of all podiatrists — New York and otherwise — but people in NYC are much more likely to believe that it’s possible to ‘cheat the system’. Fortunately, that’s almost impossible — there’s a basic State exam that every podiatrist has to pass; and if you have been to one (or are currently going to one) that can’t show you their certificate, find a new podiatrist, plain and simple.

2. Your feet are critically important to your overall health. Especially in the Big Apple where we all walk everywhere and there’s precious little soft ground to be found, even a minor maladjustment in your foot can cause everything from back pain to intestinal distress.

3. Your feet are not made to walk in shoes. Of course, it’s not exactly hygienic to walk around without shoes on, especially in a densely-packed city, so shoes have their purpose — but studies have shown that bare feet actually deal better with the millions of tiny impacts against hard surfaces that city life forces on them. The podiatrists at Midtown Podiatry are trained to deal specifically with the kinds of small problems that creep up when you wear shoes for your entire life.

4. Podiatrists are health-care professionals. Podiatry, NYC‘s opinions aside, isn’t just about bunions and ingrown toenails. Podiatrists are intimately familiar with the effects that foot health has on the entire body, and as such they have just as much if not more anatomical and systemic understanding as a general practitioner. They treat infections, diseases, and deformities of the foot just like a GP treats any general infection, disease, or deformity — just with more focus and thus greater clarity.

5. The foot is the early-warning system for your entire body. Think about gravity. The fact is that because of that ubiquitous force, many diseases from heart disease to diabetes often leave telltale signs in the foot before they appear anywhere else in the body. That makes the podiatrists at Midtown Podiatry a lot more than just someone who helps you walk right — he can and does save lives on a regular basis.

If you would like to meet with one of Midtown Podiatry’s trained podiatrists, with locations in Midtown, Gramercy Park, Wall Street, Union Square and Glen Cove, you can conveniently make an online appointment, or call us at any of the locations.

By: Paul J Betschart, DPM

Dr. John Doolan from Midtown Podiatry was recently featured on Televisa, a local New York City spanish station, discussing the effects of wearing high heels and flats.

Watch the video here.

If you are experiencing foot pain, schedule an appointment today with one of the podiatrists at Midtown Podiatry with locations in Midtown, Gramercy Park, Union Square, Wall Street and Glen Cove.