How to Avoid Foot Amputation

I have spent time in the past 4 weeks helping diabetic patients at all levels of care.  Many diabetic patients come into the office with questions about how to avoid being the other types of patients I have seen, those with ulcer or amputation.  We have all heard the stories of diabetics with an infection and needing an amputation.  My goal as a physician would be to prevent this situation.  One of my friends from Podiatry School has published a one page handout to help diabetics prevent sores, which prevent ulcers and in turn will prevent amputations.

 

Click here for a downloadable version of this article.

Don’t Live Life in Pain! Call us today for an appointment at 505.880.1000. We take care of your feet…so that they’ll take care of you!

Mark Tenny, DPM

#topdoctors #bestABQfootdoctors #nmfai #wesavesoles #fifteenyearsstrong

Fall Prevention: Leaves are supposed to fall. People aren’t.

In the early 90’s, while I was enjoying grunge music with a bad haircut, my 90 year old grandmother fell when she was out shopping.  Many times, these falls result in breaking an ankle or a hip, which require surgery, my grandmother ended up breaking her wrist and neck.  Ever since that event I have been acutely aware of the importance to prevent falls, especially of the older generation.

Fall prevention, like many other problems, begins with recognizing there is a problem.  This realization happens by noticing that you lose your balance more often or you have had a number falls in the past year.  You may also be evaluated by a physician, who will ask you a number of questions and watch you walk around the office.  These evaluations don’t take long but can be of great help if it results in you feeling more secure in walking.

Now you acknowledge you have a tendency to fall but what can be done about it.  There are some walking aids you can use to help you feel more stable.  These include; braces that give your foot a slightly wider base and support your ankle, a walker that widens your base even more or even just a cane.  These can also be augmented with physical therapy, where they will help you to adjust your gait to make it more stable.  Any of these could have helped my grandma when she fell, luckily, she recovered fully from her injuries, but it would have been even better to prevent such a fall.

Have you or someone you love had a fall recently?  If so, it is time to request a Fall Risk Assessment.  We can perform the Fall Risk Assessment and begin the process of preventing and/or changing the things that can lead to a fall.  Many times, this is a multi-team effort and we can help get you on the right track.

By making minor changes, you can lower your chances of falling.

Request a Fall Risk Assessment today!  Call us today for an appointment at 505.880.1000.  We take care of your feet…so that they’ll take care of you!

Mark Tenny, DPM

#topdoctors #bestABQfootdoctors #nmfai #wesavesoles #fifteenyearsstrong

Lisfranc

As football season begins again and we are exposed to the reasons we like to watch and for some why we like to play.  I am reminded of a little known injury that is very easily missed by ER physician, Orthopedist and Podiatrist alike, maybe because it’s named after a French gynecologist (Jacques Lisfranc de St Martin).  Lisfranc is a ligament that helps to stabilize your 1st Metatarsal.  It runs between two bones, the Medial Cuneiform and the 2nd metatarsal.  The disruption of this ligament can cause major instability in the foot.

I gave myself a review in lisfranc injuries after the opening game of the college football season 2 years ago.  Our starting quarterback sufferer this injury in the 2nd quarter, but it was missed by the medical staff and he continued to play until he kept complaining of pain causing the staff to review their initial exam to find he had suffered a lisfranc injury.  These injuries usually happen when you step in a hole or you miss a step.  In the case of our starting quarterback, he slowed down too fast on the turf.

These injuries can be devastating to the biomechanics of the foot.  If diagnosed properly and treated surgically, whether you are a professional athlete or weekend warrior, you can make a full recovery.  You will end up with some screws and pins in your foot but they are for the best and will aid in your recovery.  That quarterback is now a backup in the NFL, and we won the game in dramatic fashion.

Don’t Live Life in Pain! Call us today for an appointment at 505.880.1000. We take care of your feet…so that they’ll take care of you!

Mark Tenny, DPM

#topdoctors #bestABQfootdoctors #nmfai #wesavesoles #fifteenyearsstrong

Blisters

Blisters are a real pain in the foot, for many reasons.  I was running the other day, enjoying the thin New Mexico air, and that pain started on both my feet.  Blisters can pop up for many reasons; excess friction, excess heat, etc.  They are the separation of the epidermis from the dermis and they hurt a lot.  They are filled with clear or serous fluid or they can be filled with blood.

How do you Prevent blisters?

Most blisters form because of friction between your skin and the shoe.  The way to prevent them is to counteract or stop that mechanism.  In my case of the blisters from running I could have worn a second pair of socks, which causes friction between the two pairs of socks instead of your skin.  Another way to prevent the mechanical blister is to pad around the area to take pressure off the skin, this can be done with a felt pad or some mole skin.  The biggest key to preventing is knowing why they are happening in the first place.

Do I pop the blister?

Short answer is no, but as many rules there is an exception.  If the blister is large then yes you can pop it.  The way to do it is to just pop the side and let the fluid drain out.  Resist the temptation to remove the top of the blister, that is your protection for the dermis.

When to see a doctor

There are a few reasons to come in, one is a large tense blister.  You may need some more specific professional advice to care for the really big ones.  If there is blood in the blister, bring that one in to the office.  Lastly any blister that forms without a clear cause should be seen, as there are a number of diseases that can cause blisters.

Don’t Live Life in Pain! Call us today for an appointment at 505.880.1000. We take care of your feet…so that they’ll take care of you!

Mark Tenny, DPM

#topdoctors #bestABQfootdoctors #nmfai #wesavesoles #fifteenyearsstrong

Childhood Development: What’s normal and what’s not

Ever wonder why your child looks like they are flatfooted or pigeon-toed?  It all could be part of normal development.  I have a 5 year old and an infant so I have been watching feet grow and can sympathize with the concern

 

ed parent.  Most have heard that flat feet are bad and can cause problems in the future.  We all want what’s best for our children and many of us make huge sacrifices to achieve those goals.

Normal development:

Bowed legs are normal through the toddler years (2-4) and sometimes it is very pronounced earlier in that time frame and will slowly improve. Flat feet are common in early walkers and can stay flat through 6-8 years of age.  At this time the knee/leg relationship becomes more like an adult and children usually don’t grow out of a foot condition after about 8 years old.

 

When to see a podiatrist?

There are two main reasons to send your children to see a podiatrist for flat feet or high arches.  One is if your child can’t or won’t do normal activities.  This can be from pain when he/she does that activity or inability of the foot to perform the motion/activity.  The other reason to come see a podiatrist is he/she is getting older and the foot is still flat or has high arches.

What can be done?

If your child has flexible flat feet, meaning an arch can be created, then an orthotic is a great device to help support the foot and the muscles and ligaments that help to create an arch.  Orthotics can help prevent problems later in life.  The same can be said for very high arched feet, they just develop different problems.  If the flat foot is rigid then surgery is the best option and the decision lies with you and your surgeon to find the optimal time to perform the surgery.

Don’t Live Life in Pain! Call us today for an appointment at 505.880.1000. We take care of your feet…so that they’ll take care of you!

Mark Tenny, DPM

#topdoctors #bestABQfootdoctors #nmfai #wesavesoles #fifteenyearsstrong

I Love What I Do! – Readers’ Choice Award

I was very humbled to be chosen this year as the winner of the 2017 Readers Choice Awards for best Podiatrist.  The award was given thanks to those who voted for me this year.  I am blessed to have wonderful patients who were generous enough to take time out of their busy lives to vote for me.  As I thought about how wonderful it was that my patients voted for me for this award, it made me realize how much I love what I do and how much I love my patients.  Those I treat have brought me a lot of happiness and fulfillment.  I have the privilege of practicing medicine and keeping people active by treating their foot and ankle pain.  I have been doing this for 15 years as a private practice podiatrist and I will continue to do so as long as I can.  There have been a lot of changes to medicine that unfortunately have taken away our ability to connect with our patients but as long as we have even a few minutes in each visit to connect I will continue to listen and learn about the pain that my patients experience and diagnose and treat successfully.  The ability to connect with my patients is what continues to drive me to do what I do as well as I can.  I’m grateful for everyone who voted for me who believes in me and my ability to do my job well.  Doing what I do is much more than a job to me and the ability to get to know each of my patients is a true blessing and a privilege.  The relationships I make keep me smiling and coming to work each day.  So I thank all of my patients for sharing a tiny bit of their lives with me even if it is a complaint of pain.  Thank-you for voting for me.  Thank-you for giving me a chance to do what I enjoy and treat you.  It is easy for me to work hard at living up to being the #1 choice because I love what I do!

Don’t Live Life in Pain! Call us today for an appointment at 505.880.1000. We take care of your feet…so that they’ll take care of you!

Nathan Ivey, DPM

#readerschoicewinner #topdoctors #bestABQfootdoctors #nmfai #wesavesoles #fifteenyearsstrong

Ankle Replacement Surgery: How long will recovery take?

ankle replacement surgery recoveryI’ve been doing total ankle replacements for a couple of years now.  My implant of choice is the Wright Medical Ankle Implant because of its full, staged, revision system should revision ever be necessary.  One of the most commonly asked questions is concerning the length of recovery after the replacement.  There is a lot of different information out there regarding this subject.   Some information suggests up to a year for recovery.  I think that some of the information is implant specific so keep that in mind.  So what has my experience been?

The surgery generally takes a couple of hours.  After the surgery, most patients spend 2-3 days in the hospital.  While in the hospital, they work with the physical therapy team to ensure that they can remain non weight-bearing on the surgical extremity.  Assuming they have a good support system, they get to go home.  For people who live alone or who need further therapy, they sometimes need to go to a rehab facility prior to going home.

My patients are generally non weight-bearing on the affected ankle for 2 weeks.  After that, I let them start putting some weight on the ankle.  That does not mean that they are walking.  They are in a hard cast from week 3-4 so walking is not really possible.  However, they can put weight on the extremity to stand and to transfer.  Once the cast comes off at 4 weeks, the patient is placed in a surgical boot.  At that point, they can start walking but this is most likely going to be a transition.  Most patients start with the boot and crutches and slowly wean off of the crutches.  That can take a couple of weeks.  Most patients are returning to a regular shoe, sometimes with an ankle brace, somewhere between 6-8 weeks.

So, when are you “back to normal?”  My response is…that depends on what “normal” is for you!  Even after walking in a regular shoe, your ankle and leg can be weak and stiff.  Sometimes, further physical therapy is required.  If you had a fairly modest activity level prior to surgery, you’re going to be back to normal faster.  If you had a higher level of activity prior to the surgery, it is going to take a little longer.  And remember, low impact activity is the way to go with these implants as they will last longer.

I follow my total ankle patients very close for the first 3 months.  I then see them back at 6, 9, and 12 months.   By 6 months, most of my patients are pretty much back to what they would consider to be normal.  And while there are exceptions, this seems to be the trend.

Don’t Live Life in Pain! Call us today for an appointment at 505.880.1000. We take care of your feet…so that they’ll take care of you!

Jonathan Williamson, DPM

#topdoctors #bestABQfootdoctors #nmfai #wesavesoles

15 Year Anniversary

In July of 2002 the ink dried on the paperwork and New Mexico Foot & Ankle Institute was formed out of the ashes of a practice run by Dr. Michael Federico.  Dr. Federico had run a fantastic practice out of both Albuquerque and Artesia.  His service model was 2nd to none and New Mexico Foot & Ankle Institute was formed in hopes of taking all the good from that practice and building it up to what it is today.  We are celebrating 15 years in practice this month here in Albuquerque.  The Artesia practice was closed 7 years ago due to the cost of commuting so far.  We still miss our Artesia and Roswell offices but our families don’t miss us being gone so much.  We have grown from a one doctor practice to a four doctor practice with two locations in Albuquerque.  We continue to strive to treat our patients better than any practice in town and due to some great employees we are able to pull this off the vast majority of the time.  We plan to celebrate our 15-year anniversary all summer long with some specials for our patients to thank them for being so loyal to us over the years.  We continue to do what we do because we love the patients that come to see us.  Those relationships that have been built help us to keep going each day.  We’ll keep making those feet feel better as long our patients keep coming to see us and letting us be a part of their lives.  Thanks to everyone who has been part of the past 15 years.  Here’s to another 15 wonderful years!!

Don’t Live Life in Pain! Call us today for an appointment at 505.880.1000. We take care of your feet…so that they’ll take care of you!

Nathan Ivey, DPM

#topdoctors #bestABQfootdoctors #nmfai #wesavesoles #fifteenyearsstrong

Summer Sandals and Ugly Nails

toenail fungusWe treat onychomycosis, aka toenail fungus.

It’s finally getting warm and spring has arrived and summer is almost here.  The sandals always start to show up in clinic this time of year.  We get an influx of both new pain from the less supportive sandals and the wave of folks who realize that those ugly nails need to be treated if they are going to be showing them off in sandals.  Men and women both like to have normal nails and after a winter of hiding them in shoes it is time to figure out how to get them looking normal again.  Almost all of the cases of ugly nails come from a fungus that grows in the nail and makes them thick, discolored and ugly. Most folks have tried something the pharmacist, the neighbor, or the internet has suggested and figured out after a few months that they are getting nowhere fast with the current “stuff” they are putting on the nails.  Unfortunately, after coming to see a professional they realize that there is no quick fix for those ugly nails.  It takes a lot of work and patience to get them clear and pretty again.

Topicals as a general rule work only about 25% of the time regardless of whether it is the internet sensation or the latest billion dollar prescription medication.  That leaves you with two options, laser therapy or a pill.  A good discussion with a qualified, knowledgeable podiatrist will help you decide which option is best for you, visit our NM Laser Nail Centers site.   In some rare cases people even choose to just to remove the nails temporarily or permanently.   In all cases if you have fungus in your nails you should work with your doctor to find the quickest and most effective way to get hose nails back to normal again.

Don’t Live Life in Pain! Call us today for an appointment at 505.880.1000. We take care of your feet…so that they’ll take care of you!

Nathan Ivey, DPM

#topdoctors #bestABQfootdoctors #nmfai #wesavesoles

Wrong size shoes?

Are you wearing the wrong size shoes? A recent study done in the UK on 2000 patients shows 1/3 of men and almost ½ of women have shoes that don’t fit right.   Some people might ask how that is possible but it doesn’t really surprise those of us who work with feet every day.  What people don’t realize is that their feet change constantly over time and the size you wore in high school is not the size you should be wearing now.  To compound this problem we have less and less stores fitting people and more and more folks are just plain buying shoes online and not trying them on at all.  I often joke with people about the fact that most shoes are now being made out of the U.S. and the standards are not very high and shoes just don’t fit like they used to.  We also see routinely that a size 10 in a Nike doesn’t even fit close to the same as a size 10 in a New Balance shoe.  In the clinic each day I see people with real problems that can cause real pain.   I see at least 1-2 people a day who simply need to invest in a properly fitted and properly stable shoe.  They don’t need surgery, and they don’t need injections, casts, or prescription medications.  Just a new pair of shoes.  Find a good store where they still carry a measuring device for your foot or ask your podiatrist for your size and go get some good shoes.  What constitutes a good shoe?  That’s a blog for another day.  How often do you go to a doctor and he simply tells you to go shopping.  Probably not often but it’s a great way to prevent foot pain, so start shopping.

Don’t Live Life in Pain! Call us today for an appointment at 505.880.1000. We take care of your feet…so that they’ll take care of you!

Nathan Ivey, DPM

#topdoctors #bestABQfootdoctors #nmfai #wesavesoles