Bunion Surgery: Don't Listen To Dr. Oz!

We know that a lot of people watch the Dr. Oz show and believe everything that comes out of his mouth to be the truth. Because if Dr. Oz said it, it must be true, right?
We've encountered this scenario with Dr. Oz and the gospel truth several times in the course of his show, including one of his most famous proclamations: Don't wear flip-flops! Podiatrists across the country pounded their heads into their desks, saying "We've been saying that for years!"
Last Wednesday Dr. Oz had on his program The People's Court judge Marilyn Milian to talk about bunion surgery. At first, we were excited to see him put the spotlight on this topic. Bunions are a common foot deformity we see in our practices, and some people, not all, require surgery to correct the bone.

Dr. Oz warned viewers immediately that surgery may not be the answer to your bunion problem. "Today we are talking about a painful and often crippling condition that could affect more than half of you at some point in your life," Oz said. "Many of you will turn to surgery, but will surgery cause more problems than the bunions themselves?"
Milian discussed her surgery, which was the second time she had it done on that foot. This is an important

fact, which is not factored in to the discussion. "The aftermath is very, very, very painful and involves slow recovery," said Judge Milian, who was in the eighth week of her recovery and said that at week four she was still in terrible pain.
We're not going to go into full detail here about the entire segment (you can watch it here), but what we gleaned from it did not make us happy. First of all, when bunion surgery is done for the second time, your podiatrist needs to go in and break the bone in order to correct the deformity. Not only are you dealing with the pain from the surgery, which can be different for everyone, but from the broken bone. Naturally, this will be more painful.
Secondly, those who are in pain from bunion surgery and have problems afterwards are often those who have not followed their podiatrist's post-surgical instructions to the T. They are likely not icing often enough, elevating, staying off their feet, and taking the prescribed medications. In my career of more than 30 years, patients who follow the directions I give them have great success and recovery. Those who do not follow my instructions suffer needlessly.
Third, how Dr. Oz portrayed the podiatric field and what we do was honestly insulting. He poked fun at the instruments we use during surgery, and overall made a mockery of our field. In case you haven't been paying attention, Dr. Oz, podiatry today is not what it was even 20 years ago. Our doctors have four years of medical school, followed by two to three years of a residency, which is standard across many specialties.
It is unfortunate that the report was severely one-sided. The segment had just one patient's account of having difficulties, and he did not even let the podiatrist who was on give a rebuttal. It is true that these procedures require several months to heal, but the overwhelming majority do well and have an improved ability to carry on daily functions more comfortably.
It is advisable to correct bunion deformities when they are moderate because as they progress they tend to be arthritic and the end result is not as positive and healing is more prolonged. We encourage anyone who has a bunion deformity to speak with a podiatrist, and not listen to a surgeon's advice. Please do not be dissuaded by one person's bad experience.
If you need foot or ankle surgery and do not currently see a podiatrist, call our Bristol office to make an appointment.
Richard E. Ehle, DPM
Connecticut Foot Care Centers
Foot Deformity Doctor in CT
Podiatrist in Bristol, CT
Visit our website, like our page on Facebook, and follow my tweets on Twitter.

Victoria Beckham Considering Bunion Surgery

Victoria Beckham's bunions are so epic, they're part of popular culture.
The former Spice Girls singer and wife to soccer star David is reportedly considering surgery to correct the deformity.
Beckham was warned to have the surgery now or risk "serious problems."
The fashion designer has a notorious love of high heels, even wearing wedge sneakers when she was invited

to throw out the first pitch for a Los Angeles Dodgers game in 2007.
But there is only so long you can wear high heels and stilettos without consequence, and Beckham can expect a huge change in wardrobe if she doesn't have the surgery.
"Vic's been advised that her treatment must be done on both feet ASAP, otherwise, in less than two years, it could cause serious problems," an insider told the British magazine Heat.
"She's been told that if she allows her bunions to get worse, she may never be able to wear heels again."
Besides never being able to wear heels again, which is no tragedy, Beckham's feet will be more likely to get arthritis, face further disability, and have problems with her legs, hips, and spine because of gait issues from the bunions.
The thought of getting rid of her heels and wearing flats for the rest of her life is apparently filling Beckham with horror and she is realizing she needs to do something about her painful bunions.
"She's relenting and saying she would be swayed to do it this winter. At least that time of year, it's easier to keep her feet under wraps and wear flats," the insider said.
If you need foot or ankle surgery and do not currently see a podiatrist, call our Bristol office to make an appointment.
Richard E. Ehle, DPM
Connecticut Foot Care Centers
Foot Deformity Doctor in CT
Podiatrist in Bristol, CT
Visit our website, like our page on Facebook, and follow my tweets on Twitter.

Tips To Follow When Recovering From Foot Surgery

It's likely you've been feeling a lot of anticipation as your foot or ankle surgery date approached. It is normal to feel anxious, scared, upset, worried, or frightened about surgery of any kind. Remember however, that foot and ankle surgeries are rarely life-threatening and the outcomes will make you feel happier and healthier!
After your surgery you will be discharged from the hospital 1-4 hours after the procedure has been completed. Overnight stays are rarely prescribed, but when you get to leave the hospital is determined by your podiatrist and case manager. Previous to your surgery we will go over your discharge instructions and make post-operative appointments. These are very important to keep.
Your podiatrist will give you a prescription for medications you can take at home. Make sure to fill them and take them as prescribed. If you had stopped taking any medications before your surgery, you may start taking them again.
You will need someone to drive you home and possibly stay with you for the rest of the day. Some patients, especially the elderly, may require more care at a nursing or rehabilitation center. If you require therapy, your podiatrist and nurse will let you know. Be sure to use all equipment your podiatrist has provided you with for your post-operative care: walking boot, walking cast, bandages, crutches, and special shoes. These will help you recover quickly, efficiently, and healthfully.
When you return home, watch for signs of infection, which may include redness, fever of 101 degrees or more, swelling, and/or drainage at the incision site. You should also watch for signs of decreased circulation to the foot and ankle, which may include increase in pain, toenail beds that turn blue in color, foot or leg turns pale, coldness of your foot or ankle, and/or tingling and numbness.
You will likely experience pain and numbness for as long as 24 hours after surgery because of the mild anesthesia used at the end of surgery. After this wears off it is normal to feel moderate discomfort in your foot or ankle, as well as the sensation of pinching and pulling. When you put your foot down you may also feel throbbing. These are all normal sensations and you should not be alarmed.
After surgery elevate your foot or ankle to help with the pain and swelling. You should take your pain medication for the first week after your surgery. Take it regularly, even if you are not in pain at that moment. Do not let your pain escalate to intolerable heights. Ice your affected area 20 minutes every hour.
You will go home with a surgical dressing on your foot. Do not remove the dressing, even if it has become loose, dirty, or wet. It is normal to see your dressing soak up discharge from your surgical incision. However, if the dressing rapidly becomes bloodied, soiled, or wet, call the office immediately.
Your podiatrist may have prescribed an antibiotic to prevent infection. It is important you take the entire course of medication to prevent infection in the surgical site. If you take birth control pill, you will have to use another form of contraception to prevent pregnancy.
After your dressing has been changed and bandages have been put on, you should try not to get them wet. Avoid taking a shower, as even when you put a shopping bag over your foot, leaks can occur and may potentially cause infections at the surgical site. Consider taking a bath instead as you can dangle your foot out of the bathtub while you are cleaning up.
If you need foot or ankle surgery and do not currently see a podiatrist, call our Bristol office to make an appointment.
Richard E. Ehle, DPM
Connecticut Foot Care Centers
Foot Deformity Doctor in CT
Podiatrist in Bristol, CT
Visit our website, like our page on Facebook, and follow my tweets on Twitter.

What Is Gordon's Syndrome?

If your baby was born with clubfoot, they may also have a rare genetic disorder called Gordon's Syndrome. The condition is characterized by stiffness and impaired mobility in the ankles because the tendons in the foot are too short, causing the joints to become fixed in a permanent flexed position. Both feet are usually affected  with this disorder.
The exact cause of Gordon's Syndrome is unknown, but some reports suggest it may be inherited through an X-linked dominant manner. Most experts agree it is inherited through an autosomal dominant manner. Having just one mutated copy of the gene in each cell is enough to create the signs and symptoms of the disease. When a person with the autosomal dominant condition has children, each child has a 50% chance of inheriting the mutated copy of the gene.
Gordon's Syndrome may also present as a permanent fixation of several fingers in a bent position and cleft palate. In males scoliosis or undescended testicles may be present. The child's intelligence is not affected by the disease. The wrists, elbows, and knees can also be affected and the severity of the condition can range from individual.
Your child may have an abnormal splitting of the soft hanging tissue at the back of the throat, short stature, dislocation of the hip, abnormal backward curvature of the upper spine, drooping of the eyelids, webbing of the fingers and toes, abnormal skin patterns on the feet and hands, and a short webbed neck.
Prompt treatment after birth is crucial in treating this disorder as your child will have difficulties walking and developing. Typically podiatrists will prescribe casting, bracing, or physical therapy to realign the bones before recommending surgery.
Reference: Rare Diseases
If you have a foot deformity, call our Glastonbury or Middletown office to make an appointment.
Ayman M. Latif, DPM
Connecticut Foot Care Centers
Foot Deformity Doctor in CT
Podiatrist in Glastonbury and Middletown, CT
Visit our website, like our page on Facebook, and follow my tweets on Twitter.

Are Bunions Hereditary?

According to a new study published in the journal Arthritis Care and Research, many common foot deformities, like bunions, hammertoes, and claw toes are inherited, especially in those who are of European descent.
"These new findings highlight the importance of furthering our understanding of what causes greater susceptibility to these foot conditions, as knowing more about the pathway may ultimately lead to early prevention or early treatment," said study researcher Dr. Marian Hannan, of Harvard Medical School and Hebrew SeniorLife, who is the editor in chief of the journal in a statement.
Recent studies show that more than one third of older adults have bunions. In this study, researchers looked at bunions, lesser toe deformities, and plantar soft tissue atrophy in 1,370 study participants, with an average age of 66, who were part of the Framingham Foot Study. Researchers found that 31 percent of the participants had bunions, 30 percent had lesser toe deformities, and 28 percent had plantar soft tissue atrophy.
They found that bunions and toe deformities were heritable, but plantar soft tissue atrophy was not.
A previous study by the Arthritis Care and Research showed that bunions were more common as people aged and that women were more likely than men to have bunions.
Australian researcher Neil J. Cronin recently published a study on how high heels alter the biomechanics of the foot, says that high-heel wears should avoid towering heels when selecting shoes.
Wear heels "once or twice a week," Cronin told the New York Times, "or try to remove the heels whenever possible, such as when you're sitting at your desk."
Reference: Huffington Post and New York Daily News
If you have a foot deformity, call our Glastonbury or Middletown office to make an appointment.
Ayman M. Latif, DPM
Connecticut Foot Care Centers
Foot Deformity Doctor in CT
Podiatrist in Glastonbury and Middletown, CT
Visit our website, like our page on Facebook, and follow my tweets on Twitter.

What Is Ollier's Disease?

Ollier's disease is a rare nonhereditary sporadic disorder that occurs in 1 in 100,000 people. It presents as

intraosseous benign cartilaginous tumors that develop close to growth plate cartilage. It is not clear if the disease is caused by a single gene defect or a combination of mutations, but the irregular distribution of tumors suggests that the disease is a result of mosaicism, or error in cell division that occurs before birth.
The disorder, named after French surgeon surgeon Louis Leopold Ollier, consists of numerous endochondromas which develop during childhood. The growth of these endochondromas usually stops after you have reached your full height, but the affected extremity is often shortened and bowed due to epiphyseal fusions. Those with Ollier's disease are prone to breaking bones, have enlarged toes, a bony mass on the toe, and complain of swollen, aching limbs. Ollier's disease typically affects just one side of the body and can transform into a malignant sarcoma. The hands and feet are most affected by Ollier's disease. Sometimes injury or trauma to the toe will result in the formation of the bony irregularity or prominence.
On an X-ray, streaks of low density will be seen on the long bones due to ectopic cartilage deposits. Over your lifetime, this cartilage will calcify in a snowflake pattern. Ollier's disease is often not diagnosed until the patient fractures a bone in their foot and the endochondromas appear on the X-rays.
Only when the tumors are aggressive and destroy bone tissue will they require further treatment. Pain when at rest is also a clue treatment is needed, as it is a sign of malignancy. Surgery can be done to remove the painful and problematic endocondromas. During surgery bone grafts are used to fill the cavity caused from removing the endochondroma.
If you have a foot deformity, call our Glastonbury or Middletown office to make an appointment.
Ayman M. Latif, DPM
Connecticut Foot Care Centers
Foot Deformity Doctor in CT
Podiatrist in Glastonbury and Middletown, CT
Visit our website, like our page on Facebook, and follow my tweets on Twitter.

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• My Baby's Toe Curls- Is That Normal?
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• Have Limited Ankle Motion? It Could Be Equinus
• Young People Considering Surgery For Bunions
• What Shoes Are Good For My Bunion?

The Sole of My Foot Is Abnormally Thick!

Have you noticed that the sole of your foot is abnormally thick and almost looks like reptile scales? What you likely have is one of a variety of palmoplantar keratodermas, a heterogeneous group of disorders characterized by an abnormal thickening of skin on either the palms or soles of the feet.

There are three types of patterns of palmoplantar keratodermas, which include:

*Diffuse

• Diffuse palmoplantar keratoderma is characterized by thick, even, and symmetric hyperkeratosis over the whole of the sole. They are present at birth or during the first few months of life. 
• Diffuse epidermolytic palmoplantar keratoderma is one of the most common patterns of this condition. This too is evident at birth and is characterized by demarcated symmetric thickening of the soles, with a "dirty" snakeskin appearance.
• Diffuse nonepidermolytic palmoplantar keratoderma is an inherited autosomal dominant condition, present at birth, and is characterized by well-demarcated, symmetric keratoses, and a "waxy" appearance.

*Focal

• Focal palmoplantar keratoderma is characterized by large, compact masses of keratin which develop at sites with recurrent friction. The pattern of calluses may be discoid or linear.
• Focal palmoplantar keratoderma with oral mucosal hyperkeratosis is an autosomal dominant keratoderma that represents an overlap with pachyonychia congenita type 1 without the typical nail involvement. 

*Punctate

• Punctate palmoplantar keratoderma is characterized by tiny "raindrop" keratoses which involve the palmoplantar surface, but may be restricted in their distribution.

*Ungrouped

• Palmoplantar keratoderma and spastic paraplegia is an autosomal dominant or x-linked dominant condition that begins in early childhood with thick keratoderma over the soles.
• Palmoplantar keratoderma of Sybert is characterized by a glove-and-stocking distribution with severe symmetric involvement of the whole surface and is extremely rare. 
• Striate palmoplantar keratoderma involves the soles at birth or during the first few years of life.