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This past Tuesday, June 7, I read an article in the Columbus Dispatch about a local man who was successfully treated for sepsis at the Ohio State University Medical Center. Sepsis is a concern for any doctor to watch for in his patients, but is especially important to watch for in a podiatric setting because it occurs more commonly in diabetic individuals and often involves the feet or legs.

Unfortunately for the man mentioned in the article, even though his life was saved he still lost parts of his hands and one half of each foot to gangrene. In sepsis, a bacterial infection has spread through the body in the bloodstream. This triggers a body-wide immune response that creates tiny clots, inhibiting blood supply to tissues that require blood to remain vital and functioning. In diabetic patients, whose blood supply is often already compromised to their lower extremities, steps must be taken to prevent infections and thus sepsis and gangrene as well. While the man in the article did not know where his infection came from and his first sign of an infection was a sore throat, hospitalized patients and those recovering from surgery are often at the highest risk for sepsis. All patients, but especially diabetic patients, need to avoid any open wounds, cuts or lesions on their legs or feet. If a wound goes unnoticed, it may become infected with bacteria such as Staphylococcus aureus which can worsen and spread to become sepsis if not treated.

To prevent wound infections and sepsis, self-foot exams are very important. Identify any breaks in the skin as soon as possible. Take proper care to clean and bandage wounds and watch for abnormal changes. Pain, redness, swelling and discharge are all possible signs of infection that you should contact your podiatrist to examine immediately. If you can visibly see an infection spread from one part of the foot to another, this is also cause for prompt medical attention. If an infection is present and you develop a fever, elevated heart or respiratory rate this is indicative that the infection has spread to become sepsis and treatment becomes even more urgent. The earlier an infection is stopped the better the treatment outcome will be for the patient. Hopefully patient awareness will increase thanks to survivor stories such as the one featured in the Columbus Dispatch to prevent amputations and save lives!

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.

Just because April, or “Foot Health Awareness” month is coming to an end, doesn’t mean that people should stop paying attention to their feet! With summer around the corner, I have noticed local nail salons near the Columbus Podiatry and Surgery office appear to be extra busy beautifying people’s feet. Both men and women indulging their feet with a little pampering need to be aware of the safety of their feet during a pedicure.

While many people may know that they should pick a salon that properly sanitizes all pedicure instruments between each customer, there are additional lesser known tips recommended by the American Podiatric Medical Association for a healthy and enjoyable pedicure. While women may prefer not to have hairy legs when they know a spa employee is going to be touching them, they should try to refrain from shaving their legs before a pedicure. Even if you do not see any cuts, shaving can create tiny tears in skin that allow for bacteria to gain access and cause infection more easily. Also to avoid unnecessary cuts in the skin, never allow a spa to use a foot razor to remove dead skin from your bunions, heel calluses or other areas of the foot. Along with causing an easy entry for bacteria, cutting too deep could cause permanent nerve or tissue damage. The more commonly used method of dead skin removal at a spa by a pumice stone, foot file or exfoliating scrub after soaking the feet for a few minutes is a perfectly acceptable alternative.

If you cannot be certain that a spa properly sanitizes its equipment, a safe bet is to always bring your own pedicure set. This ensures that bacteria and foot fungus cannot be spread to your toes from a previous pedicure. Emery boards especially should always be brought from home as they cannot be sterilized. If you are having a manicure and pedicure in the same appointment, make sure a different set of tools is used for each. By using different tools for each activity, you can prevent the transfer of foot fungus or infection to your hands, and vice versa. Another way to avoid the spread of infection at the spa is to try to book your pedicure in the morning, when foot baths are typically cleanest, or to find a spa that filters and cleans its foot baths between each client.

While these are good tips for everyone to remember when having a pedicure at a spa or at home, diabetic patients should consult a podiatrist first to ensure that their pedicure will be done in the correct manner for prevention of diabetic complications in the foot. Patients with signs of fungal nails should also consult their podiatrist and not use nail polish until their potential fungal problem is resolved. By staying aware during Foot Health Awareness month and all year long, people can have a pedicure experience that is both relaxing and safe for their feet!

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.

My name is Dr. Animesh (Andy) Bhatia. I am a practicing Podiatrist in Columbus, Ohio. In an effort to offer my perspective on healthcare to the general public, I blog through my website, www.columbusfoot.com.

During Foot Health Awareness Month, I posted an educational blog about the use of orthotics on April 17, 2011. I referenced Ohio State University Football’s Spring training and one of the players, J.B. Shugarts’ use of orthotics for foot pain. On April 21, 2011, I was sent/issued an OSU Cease and Desist from The Ohio State University to remove my blog.

Isn’t this a David vs. Goliath situation? Solo podiatrist vs. The Ohio State University. I am disgusted that The Ohio State University Athletics Department would put forth the effort to issue a Cease & Desist to a small podiatry practice trying to educate the public about foot and ankle health. Is it okay for them to bully me, dictate what I blog about? As a blogger, am I not considered a recognized news entity? The information referenced about the player was released into the public domain by OSU themselves. Yet they asserted that somehow I was trying to benefit by using one of their players’ name. How is my blog considered advertising?

There have been several press releases over the last year regarding J.B. Shugarts’ foot pain. I thought tying that with the use of orthotics would be of interest to others; therefore providing education to the public regarding orthotics’ use in treating common foot conditions by having someone to relate to. Please note that I have never had a patient seek out my services from reading my blog. I blog to provide patient education and public awareness about foot and ankle health.

To top it off, I got a comment from none other than from that player’s father! And he insinuated the same thing. And threatened to report it to OSU! It is of course understandable that he feels he should be the only one milking his son’s name for financial gain, and he can by all means do so. But OSU Athletics and Mr. Shugarts Sr. need to be educated that blogging is neither considered advertising, nor does it lead to more patients or any other type of financial gain. The whole world references people in the public eye in their blogs. I could mention, say LeBron James, or Tom Brady , or Paris Hilton, if they had a foot problem. The idea is to educate the public and inform them what a podiatrist does and how to take care of their feet. I have NOT had a single patient to date because of reading my blog, and I doubt if I ever will. People are smarter than that. But not according to OSU Athletics.

For a multimillion dollar program to try to intimidate me like that, they should be ashamed. The Cease/Desist was sent by Chris Rogers. Several other cronies were cc’ed in the email, I presume lawyers or others in the department with too much free time on their hands…as they draw unimaginable salaries from you, the public.

In an effort to appease The Ohio State University Athletics Department, I immediately removed J.B. Shugarts’ name and picture from my blog.

Brett Shugarts sent this comment about my blog:

Mr.

Re: Buckeyes’ Offensive Tackle Utilizes Foot Orthotics to Stay on his Feet and Knock Opponents off theirs!

By Bret Shugarts on 2011-04-19 14:38:01

“Since you are not my son’s Dr. and have no knowledge of what his circumstnaces are but merely trying to benefit yourself by using Ohio State Football I suggest that you delete this blog. Ther Ohio State Atletic Dept will be notified as well.”

I have also blogged about Kobe Bryant, Wendy Williams – Dancing with the Stars, Scott Podsednik and Serena Williams. Oddly enough, they haven’t issued Cease and Desist orders. Their parents aren’t accusing me of benefitting from their children’s condition.

Here’s another BLOG http://ernpolia.blogspot.com/2011/04/ohio-state-tackle-jb-shugarts-says-feet.html that has a picture of Shugarts, his condition and quotes him, “I’ll be fine,” said Shugarts, who said he spent the off-season rehabbing his feet and getting new shoe inserts to help take the pressure off his feet. “They haven’t bothered me at all this spring or this winter.”

Were they issued a Cease and Desist? Are they advertising?

A few links on google-search- Shugarts foot & Shugarts Orthotics

http://www.cleveland.com/osu/index.ssf/2011/04/post_44.html

http://www.dispatch.com/live/content/sports/stories/2010/10/29/foot-injury-shortens-shugarts-playing-time.html

http://www.the-ozone.net/football/2010/Minnesota/shugartsfeet.htm

http://www.buckeyecountry.net/ohio-state-tackle-j-b-shugarts-says-feet-feel-good

http://ohiostate.rivals.com/barrier_noentry.asp?ReturnTo=&sid=&script=content.asp&cid=1143906&fid=&tid=&mid=&rid=

http://ernpolia.blogspot.com/2011/04/ohio-state-tackle-jb-shugarts-says-feet.html

http://www.daylife.com/topic/J.B._Shugarts

http://www.dispatch.com/live/content/sports/stories/2011/04/16/offensive-linemen-trying-to-fill-many-holes.html?sid=101

http://www.topix.com/forum/sports/T64Q6S11C846IM0MK

http://www.buckeyeplanet.com/forum/1907569-post824.html

http://www.scarletbuckeye.com/football-talk/8280-spring-ball-o-line-competition-3.html

http://localwireless.com/wap/news/text.jsp?sid=1087&nid=45674908&cid=19470&scid=-1&ith=1&title=OSU+Football

http://mbd.scout.com/mb.aspx?s=145&f=1079

http://www.the-ozone.net/football/2011/SpringFootball/LastLineofOffense.html

http://www.morningjournal.com/articles/2010/11/05/sports/doc4cd381ea176de630186370.txt

As I stated before, I posted my blog about orthotics on April 17^th. This article below was posted by the Columbus Dispatch on the 16^th.

http://www.dispatch.com/live/content/sports/stories/2011/04/16/offensive-linemen-trying-to-fill-many-holes.html

Shugarts’ foot feels fine

Last season, a chronically sore right foot forced Shugarts to the sideline for extended periods of several games.

The bright side of the situation was that it gave Norwell some valuable playing time as a freshman, but it’s not something Shugarts wants to repeat this fall, in his senior season.

“My foot is doing great,” he said last Saturday. “I had a great winter rehab. I got some new orthotics for my shoes and really put a lot of extra time and effort into (it). I’ve been fine all spring. (The foot) hasn’t messed me up at all.”

So… why come after me? Is there more to this than meets the eye? Maybe. I strongly believe this warrants an investigation by the media. Should The Ohio State University be able to control what I blog about? Especially when all the other sources above have done the same thing with apparently no threats issued to them?

Best regards,

In Columbus this time of year, I see many runners trying do all they can to maximize their training time for the remainder of the outdoor track season. The Capital City half marathon is this Saturday, May 7, 2011. And earlier this week the world record holder in the 800M race, David Rudisha has recently been forced to sacrifice some precious training time to deal with a minor injury in his foot.

As the 2010 Athlete of the World declared by the International Association of Athletics Federations, David knows that taking care of a foot pain in running as soon as it starts is the key to a quick recovery. He is taking a week off of training after realizing he had peritendonitis in his foot. Tendons, which connect muscles to bones, are surrounded by a sheath of connective tissue which can become irritated or inflamed in peritendonitis. Tendons themselves also commonly become irritated leading to a similar painful condition called tendonitis. Achilles tendonitis is a common ailment of athletes. As David’s condition has been described as affecting the flexor muscles of the foot, it is likely that the Achilles, or other tendons coming down from the calf muscles to attach and flex, or push the foot downward are involved.

Common symptoms of Achilles tendonitis include:

• recurrent heel pain along the back of the foot where the Achilles tendon attaches
• swelling near the back of the heel
• stiffness in your ankle that lessens as you warm up for physical activity

Runners suffering from tendonitis should make sure they are wearing running sneakers that are the best fit for their foot. They may also want talk to their podiatrist about orthotics that could help alleviate the irritation of the tendon, and thus a possible part of the underlying mechanism of their tendonitis. The Achilles tendon is both the largest and the most commonly ruptured tendon in the body so it is especially crucial to identify and treat the cause of pain near it in the heel! Heel pain can not only hamper running training, but it could indicate a more serious problem, such as a ruptured tendon, that would require more invasive treatment.

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.

As Columbus fans who attended Lady Gaga’s March “Monster Ball” concert at the Value City Arena can attest to, Lady Gaga is known for her wild fashion statements. Although she may make walking in crazy shoes look effortless as she stomps across piano keys or performs on Saturday Night Live, it may be somewhat of a painful process to pull off that look.

Women everywhere know how painful wearing even moderate high heels can be on a day to day basis. For Gaga’s “Bad Romance” music video off her last CD, the 12 inch tall Alexander McQueen shoes she chose to wear had been so troublesome to walk in that it is reported that three runway models had refused to wear them on their runway debut. Based on Lady Gaga’s visit to “The View” this past Wednesday, it seems as though her affinity for hard-to-balance shoes has only grown with her latest release. For some time she has been a fan of designer Noritaka Tatehana’s giant heel-less platforms that only offer support under the front, ball of the foot. The similarly heel-less platforms she sported on “The View” had her towering over the hosts of the show with their insane height.

While she may be pushing fashion boundaries to the extremes, Lady Gaga is also pushing her feet to the extreme and is likely to incur some foot pain as a result of her shoe wear. By not having any heel support at all, all body weight is shifted to put pressure on the front of the foot. This can cause problems such as sesamoiditis, in which two small bones called sesamoids, at the base of the big toe become irritated and inflamed. This is also a common injury in dancers who also place extra pressure on the front of their foot. Standing on the front of the foot at such an extreme angle also makes calf muscles work extra hard to maintain balance. Not only can this cause Achilles tendonitis and associated heel pain, but when that balance cannot be maintained falls, ankle sprains and ankle fractures are more likely. Because the ankle joint involves the talus bone in the foot and the tibia, with both the fibula and calcaneus, or heel bone, closely contacting the bones of the ankle joint, fractures can require serious surgery to correct and realign broken bones. Even Lady Gaga has been spotted falling at the airport in her heel-less shoes and is lucky that she did not have any serious injuries! Hopefully Lady Gaga takes care of her feet on a regular basis when she is not in public wearing crazy shoes and that she knows a good podiatrist to help prevent or treat any future problems!

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.

Last Friday, on “The Doctors” they featured what they described as an extreme cosmetic procedure where a woman had a toe shortening surgery to wear designer high heeled shoes with less pain. While this may initially sound like a crazy procedure you would only see in Hollywood, it is actually done across the country and here in Columbus to correct a deformity of the toes that can disrupt the normal function of the foot and cause pain when wearing ANY type of shoe.

Based on the images of the woman’s feet, it appears that she suffered from Morton’s toe. This is actually a problem where the first metatarsal is shortened, which is called brachymetatarsia, making the second toe appear longer than normal. In some cases, where the second toe is only slightly longer than the second this is a normal variation in the foot and will not cause pain. However, in more extreme Morton’s toe, such as the woman on “The Doctors” had, the second metatarsal begins to bear all of the body weight that the thicker first metatarsal would normally bear. Calluses and pain can develop in the ball of the foot in the area of increased pressure. This painful condition is often referred to as metatarsalgia. Morton’s toe can also cause excessive pronation, or rolling in and flattening of the arch of the foot. This overpronation contributes to the pains of metatarsalgia, as well as possibly affecting the individual’s stride enough to cause hip, back and neck pain by disrupting proper posture. In the woman on “The Doctors” it is also likely that she would have had black or darkened toenails, causing by bruising under the nail from the long second toe hitting her pointed shoes.

While “The Doctors” made this toe shortening surgery sound like a radical and extreme way to wear more attractive shoes, the real problem was that the woman was suffering from pain associated with Morton’s toe. For this woman, surgery was her best choice to eliminate the symptoms and the underlying toe deformity causing her pain. For others suffering from Morton’s toe, depending on the severity of their foot problems, there are also options such as padding under the second metatarsal to relieve pain or custom orthotics to help correct the problem.

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.

Ohio’s Major League Baseball team, the Cleveland Indians, will not be facing the Yankees until July, but many fans staying updated on the future opponent may have heard about an interesting injury of Eric Chavez, the team’s backup third baseman.

On May 5^thwhile running the bases, Chavez began limping and was helped off the field to get x-rays. The initial diagnosis by the Yankee’s team doctor was a small fracture of the 5^th metatarsal of the left foot. However, this week, it was discovered that Chavez’s bone was not broken, but he had suffered a less severe injury called a bone bruise.

People may not be aware that you can bruise the outer lining of bone, the periosteum, resulting in a periosteal bruise. A bone bruise can also be called a stone bruise, because patients will often describe it feeling as if they are stepping on a pebble or small stone every time they put pressure on the affected area of the foot. A bone bruise, periosteal bruise & stone bruiseare all describing the same injury in which there is a trauma that damages this superficial bone layer and the blood vessels coursing through it that supply nutrients to the bone cells. In many cases, including Chavez’s, the trauma is simply an excess of pressure hitting the bone while running. Underlying causes of this excess pressure on the foot can be from overtraining, underlying bony deformities such as metatarsalgia, or flat foot, the wrong type of athletic shoes, or shoes that are worn out.

Bone bruises should be treated to reduce the inflammation of the area which can often be swollen, tender, and painful. Resting the affected area, icing it and possibly taking anti-inflammatory medication are all recommended as part of a successful treatment regimen. Patients should consult with their podiatrist to ensure the most appropriate route of treatment depending on the severity of the bruise. It is also important to eliminate the cause of the excess pressure before returning to activities. This may be done by getting custom athletic orthotics, new shoes, or surgery in cases with severe underlying foot deformities.

Luckily for Chavez, it seems as though the Yankees had him consult with a podiatrist and the team physician to obtain an accurate diagnosis. It is always great news for any athlete to discover that an injury is less severe than initially believed, and that their shorter recovery period will allow them to get back in the game at an earlier date!

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.

After a long winter here in Columbus, all of us are ready to pack away our snow boots and bust out our sandals for spring! This may also be the time of year you notice that your feet aren’t looking quite as healthy as you thought they were. In winter many people pay less attention to the health and care of their feet simply because with heavy boots and socks on, they spend less time looking at them every day! With the end of the winter season, and the start of a very rainy spring, foot fungus may be an unpleasant surprise popping up.

Athlete’s foot, or tinea pedis and fungal nails, or tinea unguium are the two fungal infections most commonly seen in the foot. The reason that wet spring and a winter filled with boots bring on these organisms is that a fungus thrives growing in a warm, damp, dark, dirty place. These growing conditions make the inside of a sweaty boot or a damp sock from stepping in a puddle ideal for a fungus to grow. Once someone has a foot fungus, it can be transmitted to others by contact with the infected skin cells. This is why it is recommended to wear sandals in a public shower or swimming area, as everyone naturally sheds skin cells. The most important way to prevent a fungal infection is to keep your feet dry and clean, the opposite of the fungus’ growing conditions. Good ways to do this are by thoroughly drying in between the toes after bathing and changing out of dirty wet socks as soon as possible.

An infection of dermatophytes, the fungi that cause both Athlete’s foot and fungal nails, is characterized by itchy, scaly skin patches. Athlete’s foot typically is first seen in the spaces between the toes, and if not treated can spread over the entire bottom surface of the foot or also infect the nails. Fungal nails will typically appear thickened, brittle and discolored or with white spots that may spread to the entire nail being white. In some cases, a black, bruised nail can also lead to nail fungus.

Fungal treatment varies depending on the severity of the fungus, with nail fungus traditionally being more difficult to treat than Athlete’s foot. A variety of different topical creams including Tinactin, and Lamisil can be used that cause damage to the cell membrane and thus kill the fungus. Systemic drugs that you take orally are often needed in nail infections and can have a variety of adverse side effects throughout the body. Treatment of fungus can last for an extensive period of time. At Columbus Podiatry & Surgery, we offer thePinPointe Foot Laser as a preferred treatment method for toenail fungus, with no systemic effects and only about 30 minutes for a treatment.

Remember to check your feet this spring and that the best plan for a foot or toenail fungus is to avoid one in the first place by keeping your feet dry and clean

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.

Diabetes is becoming more and more prevalent here in Columbus, and everywhere around the world. The day a patient is diagnosed with diabetes can feel like a life sentence of future suffering from many serious medical issues. However, a new study offers hope to diabetics who would like to avoid a life filled with complications of diabetes, surgeries, pills and potentially deadly foot ulcers.

In this new research from the Joslin Diabetes Center in Boston, a group of patients who have had type I diabetes for 50 or more years without any major complications were studied. To have diabetes for this long a period of time without any eye, kidney, heart or nerve problems is considered a major feat. This study group is especially impressive because at the time they were first diagnosed, many of the glucose meters and other technological and pharmaceutical advances used today to control diabetes were not available!

Were these diabetics some sort of super humans able to magically control their diabetes without any work? The answer, of course, is no. Some members of the group were found to have a gene that reduced the number of molecules called “advanced glycation end-product” or AGEs, which are created in diabetics when excess amounts of sugar, or glucose, are in their blood for long periods of time. These AGEs are what cause the nerve damage leading up to loss of sensation and eventually the diabetic foot ulcers seen and treated by podiatrists. So, while a gene reducing this molecule was helpful in preventing some of the group’s diabetic complications, the main reason found for their success in fighting diabetes was good management.

Along with managing blood glucose levels, and maintaining a healthy lifestyle, regular foot checkups with a podiatrist should be a key part of every person with diabetes’ disease management plan. With these visits and self-exams of the foot in between visits, life-threatening ulcers, bone disease known as “Charcot foot” and other serious problems can be largely avoided. When examining your own feet, always be sure to check in between toes and on the bottoms of feet for any cuts, open wounds, or lesions. While something as simple as a blister may be harmless to most individuals, to someone with diabetes it could develop into a serious problem if it goes unnoticed. If sensation is lost in the foot and such a wound develops, the patient will not feel any pain and may continue to irritate the same area on a regular basis without noticing. A larger, more serious open wound may develop, providing a route for bacteria to easily gain access into the body and cause potentially deadly infections.

The goal I have for all of my diabetic patients is to strive to be a part of the elite group of people like those in the study who avoid any ulcers or other major complications from their diabetes. Making a dedicated effort to examine your feet and take other small measures along with regular visits to a podiatrist to keep feet healthy is definitely worth the benefit down the road of a long and healthy life!

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.