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What is it about feet that makes this Doctor Tick?

At a young age, Dr. Bramble was a focused ballet and jazz dancer, which initially peaked her interest in foot and ankle ailments. It was no surprise when Dr. Bramble announced her decision to research the wonderful world of podiatry.

Diabetic Foot Care

Diabetes is a systemic disease that can affect many different parts of the body, including the feet. The key to amputation prevention is early recognition and regular foot screenings from a podiatric physician.  In addition, you should check your feet daily for certain warning signs.

 

They include:

  • Changes in skin color
  • Swelling in the feet and ankles
  • Leg pain
  • Numbness and tingling in feet
  • Slow healing sores on legs and feet
  • Ingrown and fungal toenails
  • Cracks in the skin
  • Bleeding corns and calluses

Poorly fitted shoes or even a wrinkle in a stocking can cause a wound that may not be felt due to nerve damage or diabetic neuropathy.  If the ulceration is left untreated, it may become infected, leading to very serious consequences.

Prevention is the key in diabetic foot care.  These preventive measures are as follows:

Wash feet daily
Use a mild soap and lukewarm water. Dry your feet well, particularly between the toes.  If the skin is dry and flaky, use a moisturizer daily, but avoid applying between toes.
Daily foot inspections
Check for cuts, bruises, or any other changes in appearance. If you are unable to see the bottom of your feet, have someone help or just inspect your feet in front of a mirror.
Stop smoking
Smoking may lead to circulatory problems in the legs and feet which will slow the wound healing process.
Proper diet and exercise
Foot size and shape change over time, therefore, should be measured in length and width when new shoes are purchased. The shoes should have a wide toe box and cushioned insoles to prevent excess pressure on bony areas.
Properly fitted shoes
Foot size and shape change over time, therefore, should be measured in length and width when new shoes are purchased. The shoes should have a wide toe box and cushioned insoles to prevent excess pressure on bony areas.
White cotton socks
Avoid socks with seams that can rub and cause blisters. Also, avoid wearing socks that are too tight that can constrict circulation.
Never go barefoot
Walking barefoot can increase your risk of cuts, infection, falls and other foot injuries. Even indoors, slippers should be worn.
Avoid alcohol in excess
Alcohol can contribute to nerve damage or neuropathy associated with diabetes, increasing the possibility of overlooking and not properly treating an ulceration.
See a podiatric physician
Regular visits to your podiatric physician for evaluation and routine foot care will help your feet remain healthy and happy.

Frequently Asked Questions

Q- What are the various types of foot fungus and how do I know if I have one?

A- Foot Fungus or Tinea pedis affects 30-70% of the adult population and is usually caused by Trichophyton Rubrum. Less common organisms are Trichophyton Mentagrophytes and Epidermidis Floccosum. These fungal infections may appear between the toes or on the bottom and sides of the foot in a “mocassin distribution”. The skin is usually itchy, may appear red and scaly or have several small vesicles. It is important to consult with a physician to differentiate this from other dermatological conditions.

Q- What causes calluses and can they be safely removed?

A- Calluses are formed by increased pressure on bony prominences caused by various foot deformities.  Routine trimming, hydrating the skin with cream or lotion and padding around the lesion will alleviate pressure to the area. Arch supports may also alleviate pressure to calluses.  If these treatment modalities are unsuccessful, the underlying bony deformity can be addressed and corrected.

Q- How can ingrown toenails be prevented?

A- Ingrown nails may be prevented through proper nail trimming and by avoiding ill-fitting shoes to prevent pressure to the nail fold.

Q- I’ve been suffering from ingrown toenails for years, is there a safe and effective way to permanently remove them?

A- An ingrown toenail may be removed, but unless the nail matrix is destroyed, the nails will grow back. A common procedure among podiatrists, the Phenol Matrixectomy, is the application of an acid solution to destroy the nail matrix. Another procedure is surgical excision of the matrix, which is also effective in permanently removing ingrown toenails.

Q-Are pedicures safe?

A- When getting a pedicure, it is important to know that the instruments are properly sterilized to prevent the spread of infection. If you have diabetes, poor circulation, nerve damage or are taking blood thinners, you should consider a podiatric physician to perform your foot care.

Q- What causes plantar warts and are they curable?

A- The Human Papilloma Virus is the cause of plantar warts, also called Verruca Plantaris. It is relatively common in athletes, because of their greater use of public showers. The virus likes to live in warm, moist environments and infects directly through breaks in the skin. Treatment of plantar warts may include routine trimming and placement of a chemically treated dressing, such as 40% salicylic acid, cryotherapy or surgical excision.

Q- I have terrible bunions on my feet, what can I do to ease the suffering and discomfort that they cause?

A- Shoewear is a major contributor to discomfort from a bunion deformity. Women’s shoes, in particular, usually possess a narrow toe box, adding pressure to the area.  Altering shoegear to wider toe box and applying bunion padding may help decrease the discomfort of a mild bunion deformity. Unfortunately, severe bunions may require surgical intervention.

Q- If I have surgery to permanently remove my bunions, how long will I have to stay off my feet? Can both feet be done at once or will I require two individual operations?

A-(A.) There are many different surgical procedures to correct a bunion deformity, depending on the severity. The proper procedure is determined through clinical and radiographic evaluation. These procedures may require the patient to be strictly non-weight bearing anywhere from 2-6 weeks with a gradual return to full-weight bearing status.

A-(B.) Two feet can be done at the same time, however, it may be difficult to comply with the strict non-weight bearing your physician has recommended for both feet in order for proper healing to take place. If weight is applied too soon to the surgical site, there is a possibility of a poor result. Therefore, it is recommended to do one foot at a time.

Q- I’ve been using additional supportive inserts for my feet, but they are not working. Can you suggest another alternative for relief?

A- Arch supports or orthotic devices may help relieve pain due to arthritis, plantar fasciitis and many foot deformities. Sometimes, an “over-the-counter” device may not be as supportive as a custom molded orthotic made specifically for your feet. Although, the proper diagnosis by a podiatric physician must be made to determine the proper treatment modality.

See a podiatric physician today for an evaluation and routine foot care.

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