My Blog
By Dr. Steven Miller
May 31, 2020
Category: Medicine

Biotin containerBiotin, also known as vitamin B7 and nicknamed vitamin H, is present in many multivitamins. The recommended daily dose for adults is around 30 mcg (30 micrograms, which is much smaller than a milligram). However, some supplements promoted for hair, nail, and skin health contain biotin at much higher doses, as much as 10,000 mcg (over 30,000% the recommended daily need).

Consuming large amounts of biotin can be problematic. Some lab analyzers use an immunoassay that contains biotin. In patients with excess biotin in their blood samples, there is an increased risk of false lab values due to the inability of the patient’s blood to bind properly.

There is insufficient data to know if waiting for hours or days before running lab tests would help. Furthermore, waiting is obviously impractical when running critical lab tests such as for a heart attack or pregnancy.

By [email protected]
April 30, 2020
Category: Uncategorized

COVID-19Coronavirus (COVID-19) has changed our world. In the realm of podiatry, two issues were examined.

“COVID toes” is a red discoloration, as if there was a bruise. There may be itching and burning sensation like frostbite. It is not known whether this phenomenon is due to inflammation from coronavirus, an immune response, or increase in blood clotting (or combination thereof). Thankfully, COVID toes heal without a scar and is not seen in most patients.

Although a study from Wuhan, China found coronavirus on shoes, it is unlikely that this is a common way that the virus is transmitted. The virus on shoes would still need to enter the body and may not be viable at that time. The reason this subject became popular may be due to this excerpt from the article: “…the virus can be tracked all over the floor, as indicated by the 100% rate of positivity from the floor in the pharmacy, where there were no patients. Furthermore, half of the samples from the soles of the ICU medical staff shoes tested positive. Therefore, the soles of medical staff shoes might function as carriers.”

Image of heel painWhat causes heel pain?
Plantar fasciitis is the most common cause and spares no one, sedentary or active. This occurs when the thick band (plantar fascia) which supports the foot becomes inflamed and painful. Other causes of heel pain include stress fracture and arthritis.

How do I know if I have plantar fasciitis?
A classic sign of plantar fasciitis is heel pain when stepping out of bed in the morning. It may also hurt when standing up after a period off your feet, such as after a long car ride. If untreated, the condition may worsen. In more advanced cases, the heel may hurt all the time.

What causes plantar fasciitis?
There are many factors: type of activates, load on feet, shoes (or lack of shoes), walking surface, and foot structure. It is common for a combination of circumstances to contribute to a painful heel.

What can I do myself to diminish the pain?
  ●  Change shoes. Use new sturdier shoes with shock absorbing materials. Avoid flip flops, slip-ons, and slippers, even at home. Interestingly, plantar fasciitis often hurts less in high heels.
  ●  Cryotherapy. Apply ice to the painful area. Even better, roll your arch on a cold can or frozen golf ball.
  ●  Ibuprofen or Naproxen. The brand names for these over-the-counter anti-inflammatories are Advil, Motrin, and Aleve.
  ●  Home exercises. The most common are calf stretches and strengthening techniques, which ultimately help the bottom of the heel.
  ●  Arch supports. This may be the hardest to accomplish without professional guidance since there is a delicate balance between support, cushioning, and thickness.

In summary, multiple remedies are usually needed to cure plantar fasciitis. An accurate diagnosis and treatment plan is the first step. For expert care, schedule an appointment with Dr. Steven Miller by calling (847) 675-3400 or clicking here.

By Dr. Steven Miller
February 20, 2020
Category: Shoes

Picture of no heel heelsMany businesses in Japan require working women to wear high heels.  (Airlines in the United States have similar rules.)  Yumi Ishikawa, a Japanese actress and freelance writer, feels that’s unfair. 

Her efforts to change public policy have been bolstered by a clever hashtag: #KuToo which is a play on the Japanese words kutsu (shoes), kutsuu (pain), and a nod to the #MeToo movement.

High heels have long been seen as a female equivalent to the businessman’s necktie. Others, however, have compared such high-heel policies to foot binding, a practice in ancient China when smaller feet were seen as more desirable.

English actress Nicola Thorp made headlines after going public about being fired from a job as a receptionist for refusing to wear high heels.  Shortly thereafter, British Columbia and the Philippines passed laws banning companies from forcing women to wear high heels.

If you have pain from high heel shoes, call (847) 675-3400 to schedule an appointment with Dr. Steven Miller.

By Dr. Steven Miller
July 07, 2019
Category: Medicine

Unused and expired medicineThe preferred method for disposal of unused or expired medicine is a medicine take back option. The medicine can be brought to a registered collection site, such as a pharmacy, which safely and securely disposes them. A list of locations is available from the U.S. Drug Enforcement Administration (DEA).

The DEA also periodically hosts National Prescription Drug Take Back Day where temporary collection sites are set up for safe disposal.

The next best option for MOST medicines is to dispose of them in the household trash. First, mix the medicines (without crushing tablets or capsules) with an unpalatable substance such as dirt, cat litter, or used coffee grounds. Then place the mixture in a container such as a zip-top or sealable plastic bag; and throw this bag in your household trash.

A small number of medicines, most notably opioids (narcotics), should NOT be thrown in the trash, because this method may still provide an opportunity for a child or pet to accidentally take the medicine.  Instead, they should be flushed down the toilet when no longer needed and a take-back option is not readily available. The U.S. Food and Drug Administration (FDA) concluded that these medicines present negligible risk to the environment.

The majority of medicines currently found in water are believed to be the result of the body’s natural routes of drug elimination (in urine or feces).

Even a fentanyl skin patch that has been worn for three days still contains enough fentanyl to harm or cause death in a child, pet, or another household member. The patch should be folded in half so that the sticky sides meet, and then flushed down the toilet.

Here are two case summaries to illustrate how some medicines can result in death if they are accidentally taken by children. A 2 year old was seen drinking an unknown liquid from a stray plastic bottle. The next day she was unresponsive with labored breathing. Urine drug screen was positive.  She was determined to be brain dead after 10 days. A 15 month old was found with a buprenorphine/naloxone film wrapper in her mouth. Many hours later she suffered cardiac arrest and died.

One final note. Before throwing out an empty pill bottle or other packaging, remember to scratch out all personal information on the prescription label to make it unreadable (by someone else who may find it).

This website includes materials that are protected by copyright, or other proprietary rights. Transmission or reproduction of protected items beyond that allowed by fair use, as defined in the copyright laws, requires the written permission of the copyright owners.