Introducing “Walk Away” Bunion Surgery

A zero downtime bunion procedure is now a reality.

PA Foot and Ankle Associates is the first podiatric practice in the Lehigh Valley (and one of only two on the U.S. east coast) to offer a revolutionary new bunion correction procedure called the FastForward System. FastForward offers minimal discomfort, minimal scarring and no downtime for the patient.

Dr. Adam Teichman, Senior Partner at PA Foot and Ankle Associates comments, “We continue to offer innovative approaches to podiatric medicine with the FastForward System. This bunion procedure allows a patient to resume their lifestyle much sooner, and helps to dispel the myth that bunion surgery is painful and requires a patient to be off their feet feet for long time.”

Why is FastForward revolutionary?

A bunion, known medically as a Hallux valgus deformity, is a prevalent and debilitating foot condition that affects 23% of people age 18-65 each year. Prior to the invention of FastForward, a bunion was treated surgically by means of a bunionectomy. This foot surgery used a series of bone cuts and bone screws to realign the first metatarsal – the longest bone in the foot – with the big toe. As cuts to realign bone are by their nature traumatic, bunionectomies require the patient to stay off of their feet for a period of days, followed by a recovery period of 1-2 months. The larger the bunion deformity, the more aggressive the procedure, leading to longer recovery time and downtime for the patient. With the FastForward procedure, a patient can walk immediately after surgery (in a protective shoe) and can be back in a sneaker in 2-3 weeks.

FastForward also eliminates certain painful complications which occur in some bunionectomy patients – namely, intolerance to bone screws or bones which don’t heal correctly. These complications often required a 2nd surgery to correct.

FastForward bunion procedure uses 3D printing technology

The key to this new bunion procedure is the FDA-approved FastForward Bone Tether Plate. The unique design of this medical device, achieved through 3D printing technology, allows an as-close-as-possible match to the anatomy of the second metatarsal (3D printing allows for the fabrication of devices with complex geometries). Working through a tiny incision, the podiatric surgeon anchors the FastForward Bone Tether Plate to the 2nd metatarsal, wraps the 1st and 2nd metatarsals with suture tape, and then safely pulls the bones and big toe into proper alignment. Less drilling and bone cutting means a quicker recovery and less pain for the patient.

Previous bunion correction procedures which pulled the metatarsals into alignment, required drilling into the 2nd metatarsal, subjecting it to significant stress. For some patients, this resulted in fractures of the 2nd metatarsal. The FastForward Bone Tether Plate eliminates that complication, as it conforms to the shape of the bone and requires no drilling of the 2nd metatarsal.

More info on FastForward Bunion Correction

A Simple Probiotic Pill May Control Type 1 and Type 2 Diabetes

Over the past few years, scientists have been intensely studying the flora (a.k.a. bacteria) of the human intestine to unlock the secrets it may hold in influencing our health.

Scientists at Cornell University in New York have discovered a protein secreted by a particular form of bacteria which can shift control of insulin from the pancreas to the upper intestine. The pancreas is the organ which controls blood glucose levels in healthy individuals.

If a person has type 1 diabetes, their pancreas is unable to produce insulin. In type 2 diabetes, the person’s cells are unable to utilize insulin correctly. Yet proper insulin control is crucial to health, as the hormone regulates how cells utilize blood sugar (glucose) to produce energy. If insulin is not produced or not utilized correctly, blood sugar remains in the bloodstream, creating a host of side effects.

The Cornell research team, led by Professor John March, engineered a strain of Lactobacillus, a bacteria found in the human gut, to secrete a hormone that triggers the release of insulin in response to food entering the digestive tract.

The team studied blood glucose levels in two sets of rats. One set received a pill form of the live bacteria, which was administered for a 90 day period. The other group of rats received a placebo. The scientists found that the bodies of diabetic rats which had received the treatment had shifted control of blood sugar levels from the pancreas to the upper intestine. They also found that the diabetic rats’ blood glucose levels were up to 30 percent lower than rats which did not receive the pill. But the scientists also discovered that the cells in the upper intestine of the diabetic rats converted into cells which mimicked pancreatic cells – the same cells which secrete insulin in non-diabetics.

Interestingly, in those rats who were not diabetic, no change occurred in blood glucose levels. “If the rat is managing its glucose, it doesn’t need more insulin,”, Professor March said.

It’s important to note that the probiotic used in the research is different from the probiotic dairy products widely available. The next step is to test higher doses of the medicine to establish if the probiotic could reverse diabetes altogether.

Professor March remarked, “If it works really well in people, it could be that they just take a pill and wouldn’t have to do anything else to control their diabetes. It is likely though that it will be used in conjunction with some other treatment.”

The study was published in the journal Diabetes.

Diabetic Tattoo Monitors Blood Glucose

Any diabetic will tell you that checking blood glucose readings is a real pain in the finger. Multiple daily “sticks” with a lancet and forcing a drop of blood onto a test strip connected to a blood glucose meter is to say the least, not appealing. It also can be difficult for some patients to perform and the cost of the test strips can become very expensive.

As a result, some diabetics don’t monitor their blood glucose levels as often as they should. Unfortunately, their diabetes healthcare professionals absolutely rely on this method to make sure blood glucose levels of the patient are within normal range.

For these reasons, scientists have spent years searching for a pain-free way for patients to measure their blood glucose levels. Recently, nanoengineers at the University of California, San Diego, developed a temporary tattoo which just may do the trick. The tattoo holds a flexible, highly sensitive glucose sensor which uses a mild electrical current to measure blood glucose levels. The tattoo is painless, as it simply contains electrodes printed on thin, disposable tattoo paper.

The concept of a wearable blood glucose sensor is not new, however. In 2002, a similar device was marketed, called GlucoWatch. But the device was discontinued because it caused skin irritation in some patients, a reaction to the strength of the electrical current. But the UC San Diego sensor avoids this problem by using a lower electrical current to measure the glucose. None of the test subjects reported any discomfort while using the device.

“Presently the tattoo sensor can easily survive for a day,” says Amay Bandodkar, a graduate student researcher at UC San Diego. “These are extremely inexpensive—a few cents—and hence can be replaced without much financial burden on the patient.”

The diabetic tattoo was tested at UC San Diego and measured blood glucose levels in healthy patients as accurately as a blood glucose meter. The tattoo’s development is only a few steps away from providing the numerical values of glucose levels which diabetic patients and healthcare professionals are familiar with. This is a very promising step forward in noninvasive glucose testing for those with diabetes.

How Peripheral Artery Disease (PAD) caused this man to almost lose his foot

Gary Kautzmann of Orefield, Pennsylvania suffered with Peripheral Artery Disease for more than 10 years. P.A.D. is a condition in which arteries become blocked, restricting blood flow to certain parts of the body. In many cases, P.A.D. is caused by fatty deposits lodged in the arteries (atherosclerosis), but in Gary’s case, arteries behind his left knee had become twisted, greatly diminishing blood flow to his lower leg, foot and ankle.

Gary had always been active – running, swimming, biking, always on the move. But the P.A.D. was now causing so much pain in his calves, that it was impossible to walk even 2 blocks. As gary puts it, “it was no way to live.”

Peripheral artery disease (also called peripheral arterial disease) is a common circulatory problem in which narrowed arteries reduce blood flow to your limbs.

When you develop peripheral artery disease (PAD), your extremities — usually your legs — don’t receive enough blood flow to keep up with demand. This causes symptoms, most notably leg pain when walking (intermittent claudication).

– Mayo Clinic

Four doctors attempted to restore blood flow to Gary’s leg, all without success. During each of 4 arteriograms, a procedure in which stents are inserted into the blocked arteries to restore their shape, the surgeon couldn’t get past the twisted tangle of arteries behind the knee. But proper blood flow is necessary for your tissues, to feed the living cells, repair damage, feed muscles and nerves, and heal wounds.

A year ago, Gary developed a routine case of athlete’s foot between the toes on his left foot. The only difference was that this time, the athlete’s foot would not heal. In fact, it got worse and worse, resisting every over the counter treatment. Gary sought out Dr. Teichman at PA Foot and Ankle Associates to treat the worsening fungal infection, and what Dr. Teichman told him was unnerving.

Watch the video to discover what Dr. Teichman told Gary.

How to make it through Thanksgiving with diabetes

Oh it’s so tempting: the turkey, the gravy, the stuffing, the mashed potatoes, the carrots with brown sugar, and then of course,…. THE DREADED PUMPKIN PIE!

Careful on that gravy, sir!

 

The traditional Thanksgiving feast is basically a carb-fest, which is why we fall asleep on the couch and miss the last quarter of the Detroit game every year (it isn’t the tryptophan in the turkey that makes you sleepy, it’s all of the carbohydrates you eat). For a non-diabetic, it’s a fun day of gluttony. But for a diabetic, it can be downright dangerous.

Not to harsh your Thanksgiving buzz, but…

The turkey part of the Thanksgiving feast is just fine for those with diabetes, within reason, as long as you take it easy on the gravy. It’s everything else that will send your blood sugar into parts hitherto unknown. But if you learn what’s bad for your blood sugar and what’s not, you’ll make it through Thanksgiving and the holidays in general without a trip to the ER.

Make a Plan. Whether you’re doing the cooking or Aunt Bessie is doing the honors, know what’s on the menu and make a plan for what you’ll eat and what you definitely won’t. Anyone who’s spent a few holidays with family has a good idea of who’s bringing what to the feast, as we’re all creatures of habit. “Diabetes or not, excessive amounts of anything unhealthy should be avoided,” says Aaron Kowalski​ of the Juvenile Diabetes Research Fund, an organization that supports Type 1 diabetes research. “The challenge for people with diabetes is that they need to match the insulin they give themselves to the food they eat. People with diabetes need to plan ahead with their insulin when eating high carbohydrate foods.”

Eat in moderation. Too much of a good thing can be troublesome for diabetics. Having small portions of gravy, mashed potatoes, and candied sweet potatoes shouldn’t be a problem. They key is to follow the My Plate recommendation from the USDA: Make half of your plate vegetables, one-quarter protein, and one-quarter carbohydrates. Opt for fresh vegetables without toppings whenever possible.

Learn to love vegetables – the right ones. You can have a free-for-all with carrots, green beans, brussels sprouts, and broccoli. But corn and anything in the squash family – squash, winter squash, butternut squash, acorn squash, or pumpkin is actually a carbohydrate and needs to be accounted for in your carb allowance. Starchy vegetables like these fill the same space on your plate as mashed potatoes and desserts, and while they don’t have to be completely avoided, they should only be eaten only in small amounts. Learn to count your carbohydrates with the American Diabetes Association.

Check your blood sugar more than once on Thanksgiving. Those with diabetes should normally check their blood sugar once or twice a day. On Thanksgiving Day, diabetics should check their blood sugar two hours after eating, and every hour after that. “This will give a picture of how you’re responding to the meal”, says Paula Jacobs​, a certified diabetes educator with Methodist Charlton Medical Center in Texas. “About two hours is required for the food to be digested and enter the blood stream, so this time frame gives a good picture of how the meal is being processed by the body,”

Eat dessert if you want to, just don’t overdo it. Until recently, the medical advice for diabetics was to avoid carbohydrate-heavy desserts at all costs. Now the recommendation is to be reasonable with portion size and account for those carbohydrates in your meal plan for the day. “If you had turkey and non-starchy vegetables like green beans or carrots, then there are no carbohydrates accounted for and you’d be able to have dessert,” says Amy Kimberlain​, a registered dietitian with Diabetes Research Institute Foundation. “What you wouldn’t want to do is have the stuffing, the corn casserole, the dinner roll and dessert, because you will have well exceeded your carbohydrates allotment.”

If you’re diabetic, it’s okay to enjoy yourself at Thanksgiving, but don’t overindulge. Eat in moderation and keep track of your carbohydrates, and you can enjoy the day like the rest of the family.

Philadelphia Top U.S. City For Percentage Of Residents With Diabetes

The news for the residents of Philadelphia is not great when it comes to diabetes. Between 2002-2010, diabetes rates in the most impoverished neighborhoods of the City of Brotherly Love skyrocketed to an unprecedented percentage of population. So much so in fact, that Philadelphia now holds the not-so-wonderful title of largest city in the U.S. with the highest per capita diabetes rate.

Health researchers at Philly’s Drexel University have been studying new ways to pinpoint who is most at risk for diabetes and its most common side effect, heart disease. “Just having diabetes actually increases your risk for heart disease almost as if you’ve had a heart attack already, that’s how profound an effect it is,” said Internist Ana Núñez, a lead member of the Drexel team studying health disparities related to cardiovascular disease.

The map below shows the increase in diabetes rates by zip codes in Philadelphia. The red areas of the map represent diabetes density in the neighborhoods as high as 20.41% of the population, tan as high as 13.97 %, green as high as 10.62%, and blue as high as 7.11%. Even with the most cursory glance at the map, it’s easy to see the increase – for instance, note the lack of blue in 2008-2010 (right), compared to 2002-2004 (left). The red zones also happen to be the most underprivileged neighborhoods in the city.

Click on map for a larger view

Part of the work at Drexel’s School of Public Health has focused on the health consequences of living in disadvantaged neighborhoods. No one can ignore the glut of fast food restaurants in these neighborhoods, but the diabetes problem runs much deeper and is more complicated than that. It’s partly education, partly cultural, and partly a lack of resources.

“If you are person with diabetes, and you have to store insulin, it has to be in a refrigerator, and there are places in Philadelphia where residents don’t have resources for a refrigerator. But are you going to say at your doctor’s visit as you get your refill, ‘I don’t have a refrigerator?” Núñez said. She is also studying residents of these neighborhoods who manage to maintain good health and exercise regularly “based upon either family support, headset, motivation, or resources.”

The benefit of this information? It may be useful for policy leaders – both at the municipal, state, federal, and NGO levels – to invest in these regions to discover ways to bring down the diabetes rate and improve health overall.

Curt Schilling Shares Photo of His Stitched-Up Ankle from 2004 World Series

Do you remember when Curt Schilling pitched for the Red Sox? When he led them to their first World Series win in over 100 years?

Now do you remember the bloody sock spectacle when his ankle appeared to be hemmoraging while he stood on the plate?

 
 

 
 

Some naysayers said it was only ketchup, and that Schilling was putting on a show. But this week, Schilling put those rumors to rest when he tweeted this image of his stitched-up ankle from 2004.

 
 

 

Now we know what it looked like under that famous sock. And that it was for-real ankle injury. Wow.

We can’t even imagine the pain that Schilling endured during that spectacular game. Pitching requires an extraordinary amount of precision and control, not only from your ankles, but from your entire body. And to pitch such a legendary game with an ankle in that condition is just… SUPER HUMAN!

‘Nuff said. Back off, haters.

Diabetes Food Myths

There are a lot of myths about the foods that diabetics should or shouldn’t eat. If you’ve been newly diagnosed with diabetes, you may hear a lot of input from your friends and family about which of these foods are good or bad for your disease. Unfortunately, much of the advice you’ll hear is just plain wrong and potentially dangerous. There’s a lot of bad info online too, so it’s time to set the record straight.

I can eat all of the fruit I want, because it’s a healthy food.

Well, not exactly. Yes indeed, fruit is a healthy choice. But fruit is a carbohydrate. All carbs, regardless of their source, are broken down in the body and converted into blood sugar for energy. Therefore, all carbs – like fruit, starches, breads, and milk – raise blood sugar. Yes, healthy carbs should be a regular part of your diet, but not in “all you want” quantities. The amount of carbs you eat at any given time should be monitored to avoid a dangerous spike in blood sugar.

I can eat anything I want as long as I take additional medicine

No. More food leads to weight gain, and extra body weight creates more insulin resistance, which requires… more medicine. Extra body weight may also increase blood pressure and elevate cholesterol levels. Your metformin, insulin, or other blood glucose medicine is meant to control your blood sugar, not indulge your overeating.

All white foods are bad for diabetics

No. The initial advice from your dietician when one develops diabetes is to reduce your consumption of potatoes, white flour products, white sugar, white pasta and white rice, to lower your blood glucose levels. It’s a simple leap to include all foods that are white. Unfortunately, healthy choices get thrown in there too, like milk, cauliflower, yogurt, bananas, and bean sprouts. These last foods are actually very healthy choices, but (as above), diabetics must always count their carbohydrates.

Diabetics should definitely substitute white rice for brown rice, white bread for whole wheat or whole grain, and white pasta for whole grain or whole wheat. Whole grains cause blood sugar to rise more slowly than their white flour counterparts, and whole grain products are higher in fiber and B vitamins. But even whole grain products are carbohydrates, and must be counted accordingly.

When it comes to food and diabetes, all things in moderation, even the healthy things.