Items filtered by date: December 2011

Back in June, the Columbus Dispatch published an article on the scary reality of sepsis or septicemia, an infection of the blood that can be deadly. This past week a follow up article was run on the positive outlook of the Columbus man who survived his sepsis and subsequent below the knee amputation. With the help of a new prosthetic leg, the man is learning to walk again.
While sepsis is a terrifying infection of the blood, an often related infection that frequently occurs in the foot and leg is called “osteomyelitis”. Osteomyelitis occurs when bacteria reaches and infects the bone. As bone tries to fight off the infection, it often walls off the dead piece of bone, called a sequestrum, and attempts to envelop the piece away from healthy tissue by quickly synthesizing a weaker woven bone around it called an involucrum. Pain that feels as though it is coming from the bone, and edema, or swelling are the most common initial complaints of a patient with osteomyelitis. In order to diagnose a bone infection, taking x-rays are the first step. A timely diagnosis is imperative to prevent the spread of infection through larger areas of the bone and into the joint. If not caught early enough, like sepsis, osteomyelitis may require lower extremity amputation to prevent further damage.

But how can bacteria get to your bones through the surrounding layers of skin, fat and muscle unless you have had a bad fracture where the bone penetrated the skin? In children, an elevated amount of bacteria in the bloodstream can not only lead to sepsis, but also has a tendency to dwell in and infect the slow moving capillaries of still growing bones. This is called hematogenous osteomyelitis in which the blood has carried the igniting agent for the bone infection. In adults, “direct extension” osteomyelitis is the most common cause of bone infections, with the foot bones of diabetic patients being at a very high risk. Direct extension means that bacteria has infected a wound in the more superficial tissues, such as the skin or fat and then “extended” its way down to attack the bone. Because many diabetic patients often have lost some or all of their sensation in their feet, a small cut or irritation can quickly develop into a major ulcer by the individual unknowingly continuing to irritate the sensationless area. This injury then allows an easy route for bacteria to travel to and attack the bones of the foot. Amputation is a serious risk in diabetic patients through this process.

Amputation is a grave condition on its own for diabetic patients. Within five years of one below the knee amputation, research has shown that risk of below the knee amputation of the other leg greatly increased. The second amputation has an almost deadly effect, with increased mortality seen within the next five years. It is for these reasons that even the smallest wound or ulcer of the foot or ankle must be taken very seriously by diabetic patients. Regular self-exams and visits to your podiatrist at the first sign of injury, infection or bone pain in any patient are critical to preventing and treating these deadly conditions.

Please visit www.ColumbusFoot.com for more information or call 614-885 FEET (3338) to schedule an appointment with a podiatrist in Columbus, Ohio. Columbus Podiatry & Surgery is located on the North side of Columbus, Ohio near Worthington.

If you are planning on taking a tropical vacation away from cold Columbus winter this year, there is one item that should be packed in everyone’s suitcase: sunscreen. While many people are getting better about covering their faces and shoulders, the feet are often a missed spot when it comes to sunscreen application.

Increased exposure to the sun leads to an increased risk of several types of skin cancer including basal cell carcinoma, squamous cell carcinoma and the more deadly melanoma. As the tops of your feet are often exposed in warmer weather, whether laying poolside or when out walking in flip flops, it is crucial to protect this area by using sunscreen. It is also extremely important to examine for the development of any new lesions or changes in markings on your feet regularly through self-exams. At the first sign of a noticeable change in the skin of your foot you should contact your podiatrist to catch any potentially malignant lesions early on. The prognosis for a melanoma is related to how deep the tumor is able to grow into the tissues in your foot. The more time a tumor has to grow deeper into your foot, the more deadly it becomes. By catching a tumor early through regular self-exams, you increase your chances of having it treated before it can invade local tissue or metastasize throughout your body.

Like anywhere else on the body, in the foot you want to watch for the “ABCDs” of pigmented, or dark colored lesions including moles and anything darker colored than the normal surrounding skin. “A” stands for asymmetrical shape or pigmentation, “B” stands for borders that are irregular or indistinct, “C” stands for any changes in the lesion, and “D” stands for a diameter of over six millimeters. If you notice any of these features on a skin lesion in your foot it can be an early sign of cancer development and you need to contact your podiatrist who can then do a simple biopsy to check for any abnormal cell growth. It is also important to recognize that while some cancers in the foot may display these “classic” signs to indicate their cancerous nature, skin cancer in the foot can also have a more atypical presentation including being scaly or non-pigmented in which they will be the same or a lighter color than the rest of your normal skin. Cancer of the feet can also appear similar to other typical ailments of the foot. For example, a case of tinea pedis, or “athlete’s foot” that does not resolve with the normal treatment for tinea pedis may require a biopsy to rule out other conditions that can include an atypical skin cancer.
Keep skin safe on all tropical travel this year with sunscreen use and with fair-skinned individuals especially taking further protective measures using clothes or sticking with the shade! Happy travels and take care of your feet no matter where you choose to go!

Please visit www.ColumbusFoot.com for more information or call 614-885 FEET (3338) to schedule an appointment with a podiatrist in Columbus, Ohio. Columbus Podiatry & Surgery is located on the North side of Columbus, Ohio near Worthington.

An Ohio woman has recently developed a new invention that may of benefit to podiatry patients whose toenails have gone missing! “Nail Creations” is an artificial toe nail that can be stuck on to the skin for all those who may have lost a nail due to toenail fungus, injury or other disease process.

While this addresses a cosmetic non-medical complaint after the toenail is already lost, it is important to consult your podiatrist at the first signs of nail changes to ensure adequate medical treatment against serious infection and disease and perhaps prevent the loss of the nail entirely!!

Nail fungus or onychomycosis is one of the most common disease processes that affect the toe nails. The process of a nail fungal infection begins with some form of trauma. This trauma can be something noticeable such as dropping a heavy item on your toenail or something occurring on a continuous basis going unnoticed. Foot deformities such as hallux limitus, in which the movement in the joint of the big toe is restricted, can cause the toe to regularly undergo small trauma by slamming against the inside of your shoe with each step. If an obvious trauma has happened a bruise under the nail may be seen as a black toenail. Athlete’s foot or a tinea pedis also typically precedes the infection of the nail. This fungal infection of the skin then moves into the toenails where the organisms causing the infection, commonly dermatophytes, thrive by eating the keratin that makes up the nail.

All fungal infections should be treated to prevent spread and worsening of what can be a painful condition. Treatment of a fungal infection once it has reached the nails is more difficult than when only the skin is affected. Oral medications are often needed that often have a variety of adverse side effects throughout the body. At Columbus Podiatry and Surgery, we offer the PinPointe Foot Laser to treat nail fungus in our office in about 30-40 minutes without the harmful side effects. Along with this treatment, it is also a good idea to be examined and treated by your podiatrist for any deformities that may be exposing your nails to unnecessary trauma and making them more susceptible for future infections. With such treatment options not only are you keeping your feet healthy and preventing future fungal infections, but you also may prevent the loss of your toenail in the first place! So while the “artificial toe nail” is a great option for those who have already lost their toe nail, preventing toenail loss is even better!

Please visit www.ColumbusFoot.com for more information or call 614-885 FEET (3338) to schedule an appointment with a podiatrist in Columbus, Ohio. Columbus Podiatry & Surgery is located on the North side of Columbus, Ohio near Worthington.