By Hannah Wallace
“We have 28 bones in the foot,” says Dr. Paul Yungst of the Sarasota Foot Care Center. “All the joint structures are different.” Within those differences, so many things can go wrong. One breakthrough in the diagnosis—as well as the treatment—of myriad foot problems has been the use of good old ultrasound: It’s fast, it’s cheap and it’s changing the way podiatrists work.
In the past, Yungst explains, a podiatrist’s primary diagnostic tool was the X-ray—an accurate in-office solution for bone issues. However, for soft-tissue damage, the doctors could only palpate the area during a clinical exam and/or send the patient off to an expensive, time-consuming and out-of-office MRI scan. But with ultrasound, whether the issue is bursitis, neuroma or plantar fasciitis, doctors can see the area instantly and often make a diagnosis in a matter of seconds rather than days. “I can see if [a mass] is fluid or if it’s fibrous,” says Yungst. “I can visualize the neuroma. I can visualize the plantar fascia and pinpoint the area where it’s most inflamed.”
Ultrasound-guided injections have already proved invaluable for doctors—especially pain specialists—whose work focuses on larger joints. In the foot, precision is even more important. “The joints of the foot are very, very small, relative to the knee or shoulder,” says Yungst. “With the ultrasound I can identify [exactly] where the joint is located. Our success rate is much higher.”
High-Tech Podiatry Breakthroughs
Bioengineered Alternative Tissue: These new wound-care “patches,” resembling actual skin grafts, include growth factors that speed up healing. Used, for instance, on diabetic patients who have developed ulcers.
Internal Fixation Devices: Reconstructive foot surgery now utilizes a variety of devices for precision and strength, including cannulated screws that can slide down a wire to an exact location; headless screws, which can be made flush with the bone; and plates that are each designed to fit a specific joint in the foot.
Laser Fungal Treatment: For toenail fungus, a specially designed laser has been shown to be even more effective than topical or oral treatments. It requires only three sessions with the laser, and then eight months or so for the healthy nail to grow out.
Don’t Fear the Flu Shot
Though this year’s flu got an early start, March is traditionally a big month for Florida flu season.
It’s a familiar refrain: “I won’t get a flu shot because I believe it will give me the flu.” Wrong. “The shot is made from a killed virus—totally inactivated,” says Dr. Philip Rubin, a Sarasota family practice physician with Intercoastal Medical Group.
But two phenomena continue to fuel this flu shot myth: The first, says Rubin, is that the flu shot activates your immune system (in fact, that’s the whole point), which might lead to slight achiness and other symptoms.
The second reason for the flu shot’s bad reputation, he says, is that, “More commonly, people get the flu shot, and then just by coincidence they get sick—runny nose, cough, sore throat—and they call that the flu. But they don’t really have influenza.”
The bottom line: “There’s very little risk to [getting a flu shot],” says Rubin. “And the more people who get the flu shot, then theoretically the less it’s going to get spread around.”
“People come into a doctor’s office as soon as they start to feel sick because they want to ‘nip it in the bud.’ When you have a virus, there’s nothing to nip.”
—Dr. Philip Rubin
You’ve probably heard by now that touching your toes and counting to 10 is not the best way to prepare for exercise.
In fact, some experts believe static stretching may even cause the muscles to resist lengthening—which would make them more prone to injury. So what to do? Dynamic stretching incorporates gentle muscle lengthening with movements that double as a decent warm-up for your cardiovascular system, too. Here are some examples of dynamic stretching:
FRANKENSTEIN WALK: Extend your left arm directly in front of you. In a single motion, swing your right leg forward to touch your toe to your hand, then let it fall and step forward. Repeat with your right arm and left leg, so that you march 15 or 20 yards like a Frankenstein’s monster—if he had long, flexible hamstrings.
BUTT-KICKS: As you jog, flex your hamstrings so that with each step your heel connects with your rear, lengthening your quadriceps.
CARIOCA: For this sideways jog that loosens legs as well as torso, take a stride by crossing your left foot over your right, then step sideways with your right foot. Next stride, cross your left foot behind your right, and so forth. Then repeat in the opposite direction (right crosses over left, etc.).
Hullabaloo Family Health Festival
Saturday, March 23, 9 a.m. to noon
Doctors Hospital of Sarasota
This free event will include health screenings, trauma information, “look-alike drug” safety and yoga demonstrations, as well as representatives from YMCA youth sports, the Sarasota Fire Department, the American Heart and American Diabetes associations. The “Teddy Bear Clinic” invites kids to bring their teddy bears to be “treated” by the ER team.
How to Choose a Continuing Care Community
Senior Friendship Centers’ Nancy Hobson, who has more than 25 years experience in continuing care communities, outlines 10 tips for finding your fit.
1. Don’t wait too long to consider a retirement community as an option. Stay ahead of the curve, while your heath is stable and you’re able to enjoy amenities and friendships.
2. Education is power. Do your research via the internet and magazines, as well as by talking with friends, family and your physician.
3. See for yourself. Understand that retirement communities may have similar housing components, amenities, pricing structure and guidelines for living well, but each may vary in how these are carried out.
4. For each community you consider, ask these questions: What is its mission? How is that mission publicized and lived out on a day-by-day basis? How involved are community members in important decisions affecting their life? What is the community’s reputation?
5. Keep this phrase in mind: “Touring doesn’t carry any obligation.” This will allow you to tour and ask questions without guarded thoughts.
6. Understand the guidelines for moving to another level of care within the community. This will help you to minimize moves and understand services, prices and the community’s interpretation of “aging in place.”
7. Ask to see any regulatory surveys for the last three years. You’ll be able to see how professional agencies rate communities at all levels of care and services.
8. Look at the faces of the residents at all levels of housing. Do they look happy to you? Ask people how they feel about being there.
9. Proactive thinking helps. Visualize yourself living there five years from now. That way, you’ll feel comfortable about your choice—both now and in the future.
10. Finally, aim for the community that feels the best to you, promotes your sense of happiness, is able to meet your need for financial security and will encourage you to develop friendships. Overall, ask yourself, “Do I feel excited about this? Do I trust the staff and look forward to their friendship, too?”
SRT-100 Skin Cancer Treatment
The latest technology for treating skin cancer has just come to Sarasota by way of West Coast Dermatology: Superficial radiotherapy (proprietary name SRT-100) applies targeted radiation to the affected area of the skin. The experience is similar to an X-ray. “Your surrounding tissue is protected by lead—like the lead vest you’d wear getting X-rays at the dentist,” says Westcoast Dermatology’s Stacey Grimmer.
The recurrence rate for SRT-100 is similar to Mohs surgery. But because the procedure is noninvasive, it offers benefits not usually available to skin cancer patients. “It’s a big deal,” says Grimmer. “You’re not dealing with scars; you’re not dealing with potential for infections. There are always complications when you’re cutting open the skin.” This reduced risk is especially helpful in low-healing, low-circulation areas—like the feet or lower leg. Plus, there are cosmetic benefits, especially when treating cancers on the face, mouth and neck. Or, if patients have multiple cancer sites, avoiding multiple incisions is a big plus.
The primary drawback, albeit minor, is that SRT-100 requires repeat visits, while with Mohs, “it’s a one-shot deal,” says Grimmer. Still, in addition to being noninvasive, the in-office SRT-100 is refreshingly time-efficient. “You’re in and out in a matter of minutes,” she adds.