8 Great Suggestions for Diabetic Foot Care

1.) Maintain a blood sugar level of 70 to 130 mg/dL before your meals and less than 180 mg/dL two hours after you’ve started your meal, with a haemoglobin A1C level that is less than 7 percent. This can be achieved through regular exercise, monitoring how often and what you are eating, keeping up with medications prescribed by your doctor, and monitoring your blood sugar as often as is necessary for optimal control.

2.) Never walk barefooted. Seashells, glass, or other ocean debris can cut your skin and cause serious infections without you realizing it. Walking barefoot on a hot pavement or hot sand can also lead to severe burns or infections. Avoid wearing sandals, as sand and other foreign bodies can still get into the sandal. Podiatrist, Cyaandi Dove, advises all her diabetic patients to choose closed shoes over flip-flops and sandals to give their feet maximum protect. She says: “Insects can still have access to your feet and cause problems with bites and other infections. Rather than saying that you should never wear sandals, I would say that you should be very vigilant when you do wear them.”

3.) Be shoe wise. Wearing shoes that are too big or too small can cause blisters or calluses. Measure your feet each time you buy new shoes. It’s is normal for adult feet to change sizes four or five times during your lifetime. Weight fluctuations, changes in the weather, and poor circulation can all alter the shape and size of your foot.

4.) Be sock wise. Choose socks that have no seams. Seams will rub against your skin and cause blisters.

5.) Wash and inspect your feet and shoes daily. Give your feet a daily wash. Inspect your feet before putting on your shoes and once more when you take them off. If you are not flexible enough to see the base of your foot, use a magnifying hand mirror. Shake out your shoes before you put them on and make sure there is no debris that will rub against your feet. Although a tiny grain of sand might not be felt, it could lead to serious infection if it is not treated properly.

6.) Trim toenails. Don’t let your nails get long and overgrown. Trim them straight across, and, if necessary, file down the edges.

7.) Use skin lotion for your feet. As a preventative, Flexitol Heel Balm can reduce the risk of infections and foot ulceration in diabetic patients keeping the skin optimally hydrated. Rub a thin coat of Flexitol Heel Balm on the top and bottom of your feet, but not between the toes. Excess moisture can also lead to fungal infections, so let the balm soak into your skin for a few minutes before putting on socks on covering up your feet.

8.) Visit a podiatrist before and after your vacation. Fungal infections tend to happen a lot more when the weather is heated and increased in moisture. Your feet might also increase in calluses because you have switched to summer footwear. Do not try to remove corns, calluses, or warts on your own. Even over-the-counter products for removing corns and warts may cause burns or damage to your skin that cannot be repaired. Your podiatrist will help you manage minor infections and ensure that they do not lead to serious complications.

Sources: http://www.digitaljournal.com/pr/1282575#ixzz2sMMwFuEF, http://www.diabetes.org.uk/Documents/Reports/State-of-the-Nation-2012.pdf

What’s at stake if Congress repeals the Medical Device Tax?

During the battle to reopen the government, a pot
With that in mind, here are some frequently asked questions about the tax.

Q: What is the medical device tax?

A: Since the beginning of this year, medical device manufacturers and importers have paid a 2.3 percent tax on the sale of any taxable medical device. The tax applies to devices like artificial hips or pacemakers, not to devices sold over-the-the counter, like eyeglasses or contact lenses.

Q: Why did Congress put the tax into the health law?

A: The law created a package of new taxes and fees to finance the cost of the health law’s subsidies to help purchase coverage on the online marketplaces, or exchanges, and the law’s Medicaid expansion. In addition to the tax on medical devices, an annual fee for health insurers is expected to raise more than $100 billion over 10 years, while a fee for brand name drugs will bring in another $34 billion. In 2018, the law also will impose a 40 percent excise tax on the portion of most employer-sponsored health coverage (excluding dental and vision) that exceeds $10,200 a year and $27,500 for families. That has been dubbed a “Cadillac” tax because it hits the most generous plans.

Q: Why do proponents of the repeal suggest the medical device manufacturers should get a break over those other industries?

A: Medical device makers say the tax will cost 43,000 jobs over the next decade and will increase healthcare costs. In a September letter to lawmakers, device manufacturers said if the tax were not repealed, “it will continue to force affected companies to cut manufacturing operations, research and development, and employment levels to recoup the lost earnings due to the tax.”

The device makers also assert that, unlike other health industry groups that are being taxed through the health law, they will not see increased sales because of the millions of people who will be getting insurance through the overhaul. “Unlike other industries that may benefit from expanded coverage, the majority of device-intensive medical procedures are performed on patients that are older and already have private insurance or Medicare coverage. Where states have dramatically extended health coverage, such as in Massachusetts where they added 400,000 new covered lives, there is no evidence of a device ‘windfall,'” the group’s letter to Congress stated.

The left-leaning Center for Budget and Policy Priorities has challenged industry assertions that the tax will lead medical device manufacturers to shift operations overseas and that it will reduce industry innovation. Since the tax applies to imported and as well as domestically produced devices, sales of medical devices in the U.S. will be subject to the tax whether they are produced here or abroad, the center’s analysis notes. Innovation in the medical device industry has slowed for reasons unrelated to the tax, the center said, noting that the health law may spur medical-device innovation by promoting more cost-effective ways to deliver care.

Q: Who else is pushing for a repeal?

A: Republicans and Democrats in both chambers – in particular those who hail from states with many device manufactures, such as Minnesota, Massachusetts and New York — have sought to repeal the medical device tax. Most recently, Sen. Susan Collins, R-Maine, has pushed for a repeal as part of larger legislation to lift the debt ceiling and reopen the government.

The Republican-controlled House has twice passed legislation to scrap the tax, including a recent measure that would have also delayed implementation of the health law by a year. In the Senate, 33 Democrats and Maine Independent Angus King voted earlier this year to repeal the tax, although the vote was a symbolic one, taken as part of a non-binding budget resolution.

Q. Who opposes the repeal?

The White House in the past has said the president would not support such a measure, although it has not commented about the issue in the current negotiations. In a statement issued last year about a congressional effort to get rid of the tax, the White House said, “The medical device industry, like others, will benefit from an additional 30 million potential consumers who will gain health coverage under the Affordable Care Act starting in 2014. This excise tax is one of several designed so that industries that gain from the coverage expansion will help offset the cost of that expansion.”

Senate Majority Leader Harry Reid, D-Nev., has said that the Senate will reject any attempts by Republicans to delay implementation of the law or to repeal the medical device tax as part of reopening the government or lifting the federal debt ceiling. But it is unclear if he would still oppose the effort if it was part of a major bipartisan compromise on the health law and budget issues.

Meanwhile, other health care providers are watching closely. In a recent blog post, Chip Kahn, president and chief executive officer of the Federation of American Hospitals, an association of for-profit institutions, wrote that if Congress reopens the heath law “to reconsider the contributions of any one health care sector that benefits from ACA’s coverage expansion, it should simultaneously address the changed circumstances of hospitals and provide similar relief.”

Source: Mary Agnes Carey, Kaiser Health News/Healthcare Finance News

“We Shouldn’t Be Doing It”: Lecturer Calls Out Serious Podiatric Myths

During his lecture entitled “Righting the Wrong: Exploding Myths in Podiatric Medicine” last month, Bradley W. Bakotic, DPM, DO, Bako Pathology Services in Alpharetta, GA called out some myths which have inexplicably become part of the modus operandi of the modern podiatrist.

“Podiatry is a little bit incestuous,” Dr. Bakotic said. “If you go to MD school, you’re taught dermatology by a dermatologist. In podiatry, you’re often taught dermatology by a podiatrist who has an interest in dermatology. It’s incestuous in the sense that we don’t get out into other disciplines like we should. We pass on ideas, and sometimes they’re frankly wrong.”

The first myth Bakotic tackled was “Soft tissue mass? Just cut it out!” school of thought.

“That’s a big one” he continued, “It’s profession-wide and can actually end up in frank negligence. I think this came from the fact that 70 percent of pedal soft tissue masses are ganglia, which are pseudo cysts. The problem is other neoplasms happen.”

“If you just cut it out blindly, you almost never have appropriate margins, so you’re going to have a higher recurrence rate,” he said. “It almost doubles. Distant metastasis also almost doubles.”

Bakotic went on to state the potential litigative repercussions of this; “When you go in and cut out soft tissue mass with positive margins, you cannot do limb-sparing surgery in the aftermath,” he said. “It has big repercussions.”

His conclusion on the myth was strong; “Cutting out soft tissue mass is something that should be left behind in this profession, we shouldn’t be doing it. We hurt people.”

Dr. Bakotic continued to dispel another myth – that acral dermatitis should be seen as tinea pedis until proven otherwise.

“When I was practicing podiatry, I wrote [a prescription] for one corticosteroid in seven years,” he said. “That’s incompetence. I was led to believe every time you saw a rash on the foot, it was tinea.”

Like many podiatric physicians, Dr. Bakotic said, he commonly writes prescriptions for antifungals.

“If you get the prescription data, you’ll see it’s an absolute fact. Only 25 percent of podiatrists prescribe a topical corticosteroid at least once a month. That’s ridiculous.”

After sharing results of studies that show nearly two-thirds of skin biopsies thought to be tinea pedis are not, Dr. Bakotic shared 10 photos with the audience, asking them to identify how many were cases of tinea pedis.

The answer? None.

“Many of us were just taught to assume everything’s a fungal infection,” Dr. Bakotic said. “When I was a student, if someone came in with dermatitis I was already running to the cabinet with the Spectazole samples.”

Source:
APMA

Beware the Flip Flops This Summer!

Summer is upon us – cookouts, laying by the pool, strolling around in your favorite flip flops.  It’s a wonderful time of year!

But recent studies are providing a warning concerning our favorite summertime footwear; “While fashionable and fun, flip-flops can actually lead to weakened and fallen foot arches — and that’s just the beginning,” says Dr. Dawn Sears, a New York City doctor of podiatric medicine and surgery. “The danger with flip-flops is that they cause both short-term and long-term harm to your feet.”

Oh no!  Does this mean summer is ruined forever because our dreaded flip flops are going to revolt and destroy all of our feet?!?

No.  Take it easy now.  Even though a press release from Dr. Sears revealed that other serious injuries from flip-flops may include plantar fasciitis, Achilles tendon injury and stress fractures of the long bones in the foot, these injuries normally occur in patients who wear their flip flops all the time.  So here are some tips on how to avoid the flip flop blues:

  • Avoid wearing flip flops 24/7: There is just not enough support for the foot to keep from causing discomfort and possibly long-term damage. Stick to short trips where you won’t be walking all that much, like to the beach and the pool.
  • Avoid wearing flip flops in challenging conditions: All that foot exposure can result in broken toes and toe nails. Never, ever wear them when operating any type of lawn equipment.
  • Don’t forget sunscreen: Feet can get sunburned too!  Don’t forget to put sunscreen down there.
  • Consider your age: If you’re older, you’re more prone to some of the above issues
  • Consider your weight: As you can imagine, bigger people are more prone to foot damage, especially in flip flops

Enjoy your summer but be sure to keep conscious of your footwear!  As always, contact the We Treat Feet Staff with any questions on the above article (or anything else!).

Source:
Livingston County News

Dos and Don’ts for Pedicures!

The APMA put out a great list of important Dos and Don’ts when it comes to pedicures – we’ve highlighted some we thought were most important.  You can also check out the poster released by APMA by clicking here.

Here’s what you should DO when consider a pedicure:

  • If you have diabetes or poor circulation in your feet, consult a podiatrist so he or she can recommend a customized pedicure that both you and your salon can follow for optimal foot health.
  • Schedule your pedicure first thing in the morning. Salon foot baths are typically cleanest earlier in the day. If you’re not a morning person, make sure that the salon filters and cleans the foot bath between clients.
  • Bring your own pedicure utensils to the salon. Bacteria and fungus can move easily from one person to the next if the salon doesn’t use proper sterilization techniques.
  • When eliminating thick, dead skin build-up, also known as calluses, on the heel, ball and sides of the feet, use a pumice stone, foot file or exfoliating scrub. Soak feet in warm water for at least five minutes, then use the stone, scrub, or foot file to gently smooth calluses and other rough patches.
  • When trimming nails, use a toenail clipper with a straight edge to ensure your toenail is cut straight across. Other tools like manicure scissors or fingernail clippers increase the risk of ingrown toenails because of their small, curved shape. See a podiatrist if you have a tendency to develop ingrown toenails.

And here’s what you DON’T DO when consider a pedicure:

  • Resist the urge to shave your legs before receiving a pedicure. Freshly shaven legs or small cuts on your legs may allow bacteria to enter.
  • If you are receiving a pedicure and manicure, don’t use the same tools for both services as bacteria and fungus can transfer between fingers and toes.
  • Although certain salons offer this technique, don’t allow technicians to use a foot razor to remove dead skin. Using a razor can result in permanent damage if used incorrectly and caneasily cause infection if too much skin is removed.
  • Don’t round the edges of your toenails. This type of shape increases the chances that painful ingrown toenails will develop.
  • Emery boards are extremely porous and can trap germs that spread. Since they can’t be sterilized, don’t share nail files with friends and be sure to bring your own to the salon, unless you are sure that the salon replaces them with each customer.
  • Don’t use any sharp tools to clean under nails. Using anything sharp makes it easy to puncture the skin, leaving it vulnerable to infection.
  • Be sure that you don’t leave any moisture between toes. Anything left behind can promote the development of athlete’s foot or a fungal infection.

Source:
APMA

Flatfeet in Children – Cause for Concern?

An article by the American College of Foot and Ankle Surgeons warns that Pediatric Flatfoot, a childhood condition can, if left untreated, result in permanent deformity in adulthood. Flatfoot deformity makes mobility and exercise painful, increasing the risk of reduced cardiovascular health and obesity.

All reasons why it is imperative for parents to keep a close eye on their childrens’ foot development – namely by having them visit a podiatrist at any sign of discomfort.

“Parents never want their child to undergo a surgical procedure,” says Mary Crawford, DPM, FACFAS, an Everett, Washington foot and ankle surgeon, “but uncorrected symptomatic flatfoot can lead to chronic pain and instability as the child ages into adulthood. Children will be on their feet for a long time to come. It’s vital to keep those feet healthy. A foot and ankle surgeon can help parents understand the options – surgical and non-surgical – for treating pediatric flatfoot.”

Not every child with pediatric flatfoot will display symptoms but many will complain of discomfort, tenderness or cramping in the foot, ankle or knee area.  It also makes participating in physical activities difficult, so parents should take note if the child is not participating in these activities with their friends.

So how do doctors diagnose pediatric flatfoot?  The DPM will evaluate the child’s foot in weight bearing and non-weight bearing positions, both in and out of shoes and will also note how the child walks and evaluates the foot’s range of motion.  For further detailed analysis, the physician may order imaging tests such as x-ray, a CT scan, MRI or bone scan.

So moral of the story – don’t mess around if your child appears to have symptoms of pediatric flatfoot as it could have direct, deleterious effects on their future health.

Source:
American College of Foot and Ankle Surgeons

Prom Season is Almost Upon Us! How to Choose the Right Shoes (for Your Foot Style & Health!)

Get Your Feet Ready For Prom!
Choosing prom shoes for girls isn’t always easy and oftentimes critical factors such as comfort and fit are overlooked because you fall in love with a certain style or color, a decision that is frequently regretted about 30 minutes into the big night.  Our goal is to encourage you and your friends/family to make smart decisions from a health perspective while still keeping it stylish on Prom Night!

Comfort, Comfort, Comfort!
Comfort needs to be the number one thing you consider with these shoes.  Period.  You’re going to be spending a really long time standing, dancing, running, etc throughout the night and the last thing you need to worry about is discomfort on your feet.

Heels or No Heels?
Heels are obviously a very popular choice for prom but they should bring some consideration before you choose the wear them – do you wear them often?  Have you had issues with them before?  Have you spent long periods of time in them?  There’s no crime in not wearing heels because if you think you may have an issue, you probably will.  Wedges can be a good compromise between giant heels and the more comfortable flats – but just make sure you give it some honest thought!

Go Your Own Way!
Don’t worry about fitting in with what all the other girls are doing – go with your own style!  It’s very likely that you’ll be able to pick out what shoes most girls are going to wear so it wouldn’t be a crime to choose something completely different.  Sure you may get some weird looks from other (jealous) girls but at least you’ll be comfortable and doing your own thing!

Have any questions or comments about choosing the right Prom shoes?  Drop us a line at info@wetreatfeetpodiatry.com or 410-363-4343.

Healthcare Hiring Continues to Increase

According to Healthcare Finance News the healthcare industry has continued to grow, increasing by 23,400 positions last month.

The biggest growth area were in ambulatory healthcare settings and at hospitals specifically in home healthcare services, which added 6,800 jobs. Physician offices added 1,000 jobs, while outpatient care centers boosted employment by 3,200 jobs and overall, hospitals job positions rose by 7,900.

Nursing and residential care facilities also increased hiring in March, although at a much slower pace, adding 200 jobs.

Source:
Healthcare Finance News

We Treat Feet Welcomes Karen Pearlstone RN to the Team!

We Treat Feet Podiatry would like to welcome Karen Pearlstone RN, BSN to it’s talented team of professionals!  A graduate of the University of Maryland with a Bachelor of Science degree in Family Studies, Karen relocated to Miami several years later where she attended nursing school and obtained her Bachelor of Science degree in Nursing.

Drawn to the nursing field due to her strong desire to nurture others, she has joined our team as Surgical Coordinator and looks forward to getting to know both the staff and patients!

Have a question or comment?  Drop us a line!  You can email at info@wetreatfeetpodiatry.com or call 410-363-4343.

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