Tag Archives: health

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

25 Nov

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.

Sign Up Now For The iRUNpigs 5K 2014

18 Aug

irunpigs 5k, i run pigs 5k, marathons lehigh valley, races allentown

PA Foot and Ankle Associates is proud to once again sponsor the 3rd Annual iRUNpigs 5k and Piglet run September 14th, 2014 at Coca-Cola Park in Allentown. The race is open to runners, walkers and kids under 12 (Piglet run).

Once again this year, PA Foot and Ankle Associates is assembling a team for the race. We’re looking for ten team members, each of whom will receive a complimentary registration, a really cool PA Foot and Ankle Associates tech shirt to wear the day of the race, and all of the swag in the standard registration package from the Lehigh Valley IronPigs: commemorative tech t-shirt, chip timing results via text message, and a free entry in an IronPigs team memorabilia raffle. There will also be prizes for overall male and female winners among age groups.

If you’d like to join our team as a walker or runner, send an email to Heather at PA Foot and Ankle Associates (marketing@pafootdoctors.com)  and let her know that you want to be part of our team. She’ll send you the details. Everybody else can sign up for the iRunPigs 5K here

irunpigs 5k

Our iRunPigs 5k 2013 team (we were known as East Penn Foot and Ankle Associates last year)

The iRUNpigs5k has been redesigned for this year to insure a safer run for everyone. As always, the race will conclude on-field at Coca-Cola Park. Over 1,000 runners and walkers have taken part in the event since its 2012 debut.

Pre-registration and online registration ends on Friday, September 5 at 11:59 p.m. If you miss the deadline, you can sign up at Coca-Cola Park on the day of the event.

100% of the proceeds benefit IronPigs Charities, a non-profit organization striving to provide educational and recreational opportunities for children in the Greater Lehigh Valley area.

Getting a Pedicure? Watch out for foot and toenail infections

24 Jul

Sure, you want your toenails to look pretty, especially during sandal season. But any podiatrist will tell you that they see patients nearly every week with foot and toenail infections acquired at a nail salon – viral infections, warts, and athlete’s foot being the main players. Before your next pedicure, you can take a few precautions which will protect you from picking up any hitchhiking bacteria, virus, or fungus that may turn into a serious foot or toenail infection.


Don’t mess with the cuticles

Even the most experienced pedicurist will occasionally cut into the cuticles, and that’s a mistake. The cuticle helps anchor the nail to the skin, and should never be pushed back or cut during a pedicure, as that’s when bacteria may enter.

You want your toenails cut into what shape?

If toenails are cut a little too aggressively on the sides, it can lead to ingrown toenails, which as anyone who’s ever had one knows, are absolutely miserable and will certainly not match your other toenails. Pedicurists should cut the nails straight or at a slight curve, along the contour of the toenail, and not down into the corners.

Clean tools, clean surfaces

There’s a chance of acquiring fungus at a salon, too, if the owners aren’t fastidious about disinfecting surfaces and tools. Pumice and emery boards shouldn’t be used more than once, and tools should always be sterilized in between clients, preferably in an autoclave, which uses high pressure steam to kill bacteria and fungus. Non-metal tools cannot be sterilized, so if they aren’t thrown away after one use, every client that follows is at risk.

At the very least, make sure you can see the pedicure tools soaking in that blue liquid called Barbicide, which barbers have used since… well, since at least your grandfather’s first haircut. There’s a required minimum of at least a 10 minute soak in a bacteriacide, according to Environmental Protection Agency guidelines. And UV lights? Not to be trusted for sanitizing. Some salons allow you to bring your own pedicure tools, which is your best protection.

No bubbles, please

Glass bowls for soaking your feet are preferred over fiberglass or plastic – any porous material allows bacteria to hide out. Whirlpool foot baths should be verboten, as the piping feeding the baths can harbor all kinds of bacteria and fungus, which love the warm, but not too-warm temperatures.

Shaved legs and pedicures demand distance

Wait on getting a pedicure for 2 days after you shave your legs. A razor creates microtears in the skin, which bacteria can easily enter, directly introducing them into the legs. This can lead to an infection called cellulitis, which is very serious and may require hospitalization.

And some should never show up for a pedicure

If you’re diabetic, you should think twice about getting a pedicure. One of the unfortunate side effects of diabetes is that sores don’t heal quickly, especially in the feet. Persistently open wounds, even nicks, invite all kinds of bacteria to take up residence, which can lead to a nasty infection in a diabetic foot.

Other people at high risk include those with HIV, those going through chemotherapy, and those who have circulatory disorders or vascular disease. And if you already have an ingrown toenail, avoid pedicures entirely and see your podiatrist for treatment.

We can send toenail fungus on its way with only a few treatments.

Fried Foods Tied To Increased Risk Of Diabetes

23 Jun

The American Journal of Clinical Nutrition released new research this week, demonstrating a link between eating fried foods and developing Type 2 diabetes and heart disease.

fried foods heart disease diabetes

But the study also suggested that not all frying oils are equally dangerous, or pose the same health risks.

The research team, led by the Harvard School of Public Health’s Department of Nutrition and Epidemiology, analyzed diet and disease data from a group of more than 100,000 women and men. They concluded that those who ate fried foods four to six times a week, saw their risk for developing Type 2 diabetes spike 39%, compared to those who ate fried foods less than once a week. Coronary disease jumped by 23% in the same group.

That level of consumption of fried foods equates to almost one meal of fried food every day. But the real culprit in the study is the widespread use of the kind of oil used to fry foods – partially hydrogenated vegetable oil, the king of trans-fat. Margarine and shortening are hydrogenated vegetable oils as well.

“Trans fat is made by adding hydrogen to vegetable oil through a process called hydrogenation, which makes the oil less likely to spoil. Using trans fats in the manufacturing of foods helps foods stay fresh longer, have a longer shelf life and have a less greasy feel.

Scientists aren’t sure exactly why, but the addition of hydrogen to oil increases your cholesterol more than do other types of fats. It’s thought that adding hydrogen to oil makes the oil more difficult to digest, and your body recognizes trans fats as saturated fats.”  – Mayo Clinic.

Oils with trans-fats are the worst for you

All cooking oils break down when they’re heated to the temperatures required to fry foods. Most importantly, the structure of the fatty acids change. Oils with trans-fats create a high level of oxidative stress in our bodies, which means that we can’t neutralize all of the antioxidants these fats create. As a result, the substances thrown off by the heated oils are stored in our fat tissues and lead to a host of health problems, including Type 2 diabetes and heart disease, as well as high cholesterol, obesity, and hypertension.

Especially troublesome is the fact that restaurants re-use these oils to fry and fry again, which makes them even more dangerous. It’s one of the reasons New York City cracked down on the use of trans-fats in restaurants. The benefit to restaurants is that they last longer and can be reused, but unfortunately, that also makes them toxic for humans.

To be fair, many restaurants have reduced their use of trans-fats in cooking oils, but they’re still prevalent in some chains, and ubiquitous in prepared foods.

A co-author of the study, Leah Cahill, research fellow in nutritional sciences at the Harvard School of Public Health, says that past research hints that cooking oils which are free of trans-fats may pose fewer health risks. But as far as which fried foods you should eat, and which ones you shouldn’t, that’s too complex a question.

If you’re really craving fried chicken tonight, cook it at home in peanut oil (as in this recipe from Bon Appetit), olive oil, or even lard. Any of these cooking oil choices is safer than buying it from a fast food restaurant which uses the same oils over and over again.

But of course, fried chicken is a heavyweight when it comes to calories, regardless of trans-fats or good fats. So if you’re on a weight management program, it’s probably a road you shouldn’t go down at all.

If there was a report card for foot care, you’d get an F

11 Jun

Unfortunately, when it comes to foot care, most of you are failing miserably. Well maybe not YOU, because you’re reading this, but everyone else is failing…

foot pain foot health

The American Podiatric Medical Association has released a very illuminating survey on American’s attitudes and experiences concerning their foot health. The results are very surprising to us in some ways, and completely predictable in others, based on the patients we see. Unfortunately, your feet continue to rank low on the list of body parts you consider important to your well-being, and you’re paying less attention to them than you should.

The survey, released in March, shows that 8 out of 10 of you have experienced foot pain at some time in your life. Those of you who’ve experienced foot pain on a regular basis, also report regular issues with other health complications, primarily back pain, eyesight issues (probably diabetes-related), arthritis or other joint pain, weight issues, knee pain, and heart and circulatory disorders.

Half of you said that foot pain has restricted your activities in some way: walking, standing for long periods, exercising, sleeping, going to work, or playing with your children or grandchildren.

You said that you understand how important foot health is, and that consistent or chronic foot pain can indicate other health problems.  You also said that you understand what a complex mechanism the foot is and that a podiatrist is best qualified to treat your foot pain.


You also reported that you have little knowledge of or experience with podiatrists. When a foot problem arises, you’re more likely to visit your primary care physician for help, or try and treat it on your own. But those of you who have visited a podiatrist give them high marks for care and are more satisfied with the outcome than those of you who were treated by your primary care physician.

This last fact highlights a common misperception about the healthcare system – that your primary care physician is some kind of wizard who knows how to treat every conceivable ailment. While we respect our fellow physicians, every MD’s training is different. Primary care physicians are a sort of first line of defense and are trained to identify and treat the most common illnesses and complaints in the population. They’re also trained to flag unusual symptoms and to refer out injuries and disorders which are best treated by a specialist. Yet 60% of you say that you would talk to your PCP about a foot condition before seeking advice from a podiatrist (we understand however, that some insurance plans require this). Hello? Podiatrists know more about foot and ankle injuries and disorders than any other physician. When given the choice, always opt for a specialist.

Shame on you: Only 32% of you report doing foot, ankle, or leg exercises to keep them strong, and only 43% wear proper, supportive footwear (that explains all of the comments/questions on our blog post about why your feet hurt). Speaking of footwear, 71% of women who wear high heels experience foot pain which they directly attribute to wearing high heels. Yet they own NINE PAIR (!).

Unfortunatley, nearly 50% of you experiencing foot pain wait until it’s severe to see a podiatrist. Most of you don’t even consider a visit to a podiatrist for conditions like persistently sweaty or odorous feet, blisters, pain from high heels, hammertoes, problems with your toenails, or even diabetic wound care. Yet each of these conditions can indicate a more serious potential problem or set of problems. Treated early and properly by a podiatrist, your pain and discomfort can be relieved without further complications. In fact, 34% of you said that a podiatrist helped you identify other health issues such as diabetes, circulatory issues, or nerve damage.

But what is up with the fact that only 74% of you report keeping your toenails trimmed?  OMG! What are the other 26% of you doing? Do you have man servants to trim your toenails for you? Or extra long shoes to accommodate your lavishly long toenails?

Click here to read the entire APMA survey.

What Your Feet Tell You About Your Health

28 May

foot health

Seems to us that every general physician should ask you to take your socks off. Even if you’ve gone to see your doctor complaining of a chest cold, an inspection of your feet might inform them of the early symptoms of many conditions.

Our feet are farthest from our hearts and spine, so in many cases they’re the first area to indicate problems with the nerves or circulatory disorders. The brain and internal organs receive blood before our toes and feet do, so our appendages are the first to suffer.

Nine health problems which first show up in your feet

1.Always cold feet could be a sign of hypothyroidism, a condition in which your thyroid gland is underperforming. Most common as we approach middle age, hypothyroidism can also cause hair loss, fatigue, weight gain, and depression. A simple blood test ordered by your doctor can confirm this condition, and daily oral medication can get your thyroid gland functioning properly.

2. Suddenly hairless toes and feet could be a sign of a circulatory disorder, as your feet may not be receiving enough blood flow to sustain hair growth. Your doctor should check for a pulse in your feet, and if she has any doubts, should order a thorough cardiovascular screen.

3. Foot cramps that won’t quit may indicate a nutritional deficiency or dehydration. Sure, everybody’s feet cramp up now and then, but what matters is how often and how severe. If you exercise a lot, make sure you drink plenty of water to hydrate your muscles. You also should eat a balanced diet with plenty of potassium, magnesium, and calcium, as a lack of these nutrients can also cause cramping (good sources are nuts, leafy greens, and dairy). To relieve cramps in your feet, stretch your toes up, not down. If the cramping in your feet just won’t let up, see your podiatrist so that he or she can test for circulation issues or nerve damage.

4. Yellowing toenails is a sign of aging, but may also indicate a fungal infection. Yellowing can also occur when you wear nail polish for months without a break. If your toenails are flaky or brittle, you probably have a fungal infection and should see a podiatrist for treatment.

5. Flaky, itchy, or peeling skin between your toes is a sure sign of athlete’s foot. Even if you’re not an athlete, it’s easy to pick up a case of athlete’s foot if your feet are crammed in shoes all day or you walk barefoot in common areas like a sauna or swimming pool. Use an over the counter creme to relieve the symptoms, but if your flaking, itching, or peeling continues, you may have psoriasis or eczema. Your podiatrist can determine which is which and suggest a course of treatment.

6. Your big toe suddenly becomes swollen and painful. This is an almost sure sign that you have gout, a condition that inflames the joint. But it might also indicate inflammatory arthritis or infection. If it’s due to trauma, like someone landing on your foot after a jump shot, well, you’ll probably figure that one out.

7. A sore on your foot that won’t heal is a common side effect of diabetes, skin cancer, or circulatory disorders. In the case of diabetes, blood glucose levels that have raged out of control for long periods lead to nerve damage and small blood vessel damage, which in many cases appears first in your feet.  If the sore gets infected, it can lead to an amputation. But a sore on your foot – even between your toes – can also indicate certain kinds of skin cancer, so be sure to have it checked out by your podiatrist as soon as you discover it.

8. A slowly enlarging “growth” aside your big toe is probably a bunion. Faulty, inherited foot structure leads to this common foot deformity, which can be exacerbated by poor choices in footwear like high heels and flip flops. Unfortunately, bunions rarely stop growing, so that small, slightly sore bump today may be quite large and painful years from now. The only sure way to correct a bunion is with surgery. Splints, toe separators, and the like are temporary measures which will relieve symptoms, but won’t stop the deformity from becoming worse.

9. Pain in your heel may indicate plantar fasciitis, an inflammation of the tissue which connects your heel to your arch. If you have a sharp pain in your heel when you get out of bed in the morning, which slowly subsides as you move around, you probably have PF. There are many causes of plantar fasciitis, but primarily poor footwear, obesity, or working out too aggressively are to blame. To relieve minor symptoms of plantar fasciitis, ease up on your exercise program, lose weight, or wear shoes which support your feet properly. If symptoms persist, see your podiatrist for treatment.

New Study Shows Big Diabetes Spike In Children

9 May

A study published this week in the Journal of the American Medical Association shows an alarming increase in the rate of diabetes among those under twenty years of age: Type 1 Diabetes has increased by 21 percent, and  Type 2 diabetes has increased by 30 percent. The study tracked data reported by medical professionals between 2001 and 2009 from 3 million children in 5 states.


The new study found a particularly big increase in Type 1 diabetes among black and hispanic youths. In Type 1 diabetes, a patient’s immune system attacks cells in the pancreas that make insulin, a hormone required to control blood sugar levels. Historically, children affected by diabetes were most often white.

Dr. Dana Dabelea, the lead author of the study and a professor of epidemiology and pediatrics at the Colorado School of Public Health, called the increase in Type 1 diabetes among youth “particularly worrisome.” Statistically, some black and hispanic children have historically been less likely to control their high blood sugar, and were more likely to suffer complications of diabetes, like eye disease, kidney disease, heart disease and limb amputations. If that trend continues, it will be overwhelming for the public health system.

Type 2 diabetes is thought to occur when there is a genetic predisposition to insulin resistance, usually made worse by obesity and inactivity. Until the mid-90’s, Type 2 diabetes was very unusual to see in children, and was even called “adult-onset” diabetes. But during the last half of that decade, diabetes rates among youth started to inch up to what are now historically high levels and what some may classify as epidemic levels.  The study’s authors believe that the uptick may be the result of “minority population growth, obesity, exposure to diabetes in utero and perhaps endocrine-disrupting chemicals.”

Unfortunately, this increase among youth will have vast public health consequences. As the children become young adults, they will suffer the complications and side effects of living a decade or more with diabetes. Additionally, their children, having been exposed to the disease in utero, will also be at risk for diabetes.

The research was funded by the Centers for Disease Control and Prevention and the National Institutes of Health and is part of a continuing study, Search for Diabetes in Youth, examining the condition among children.

Learn how PA Foot and Ankle Associates is helping to find a cure for diabetes.

How To Run Downhill

1 May
We bet you think running downhill is the easiest, most natural thing in the world, right? Well believe it or not, when it comes to training for long races, there’s actual technique involved in running the downslope. And a significant risk of injury.

woman running downhill

Descending while running feels easy – like you have to actually hold back. But each step downhill can produce muscle-damaging contractions in your quadriceps and lower legs, according to Greg Wells, Ph.D., an exercise physiologist at the University of Toronto. When running on level ground, these same muscles shorten as they fire, but on declines, they elongate and control your speed, creating micro-tears in the muscle fibers. While these tears ultimately lead to growth in the muscle, they also leave you tired and sore. It’s why the cruel planners of the Boston Marathon torture all of the competitors with a 4-mile downhill opening stretch.

If you’re planning on running a marathon or even a 5K with significant downhill territory, you should practice running downhill to prepare your legs and the rest of your body to handle these very specific muscle demands. Your overall performance will vastly improve for any race, because the muscle you build from the downhill terrain will help you run faster uphill or on level ground with less effort.

Practice running downhill

You can build your downhill muscle with either focused repeats or by running a hilly route. But choose your hills wisely and don’t go too steep, too soon, or you risk injuring your ankles, knees, and hips.

Start with a medium length gradual slope, not a steep decline. And look for a soft surface like grass or gravel, not a paved surface. If you’re training for a long distance race, ultimately you want to combine both kinds of surfaces.

How you hold your head during the downhill training is crucial. Don’t look at your feet – maintain an upright posture and focus your gaze 15 meters in front of you, eyes straight ahead. You may feel a natural tendency to lean backward and slow down, but resist this. Instead, engage your core muscles, lean slightly forward from your ankles, and align your upper body over your lower body. As you descend, take shorter steps, but quicken your cadence. This way, you’ll take lighter steps and land on your midfoot instead of braking with your heel. Also keep your landing leg slightly bent to avoid letting your knees take all the impact.

Training for the race

If you’re planning to run a race filled with downhills, make sure they’re in your training schedule from the get-go. Start small with one downhill training session every other week. When you find that you easily recover from that workout, increase your schedule to one downhill each week and eventually increase that to 2 downhills per week. But only run that second one when you’re sure you’ve completely recovered from your first – no soreness in the legs, knees, ankles, or hips, and no fatigue at all. As race day draws near, dial back these workouts to avoid over exertion and the risk of injury.

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