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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).

By Dr. Steven Miller
February 04, 2019
Category: Injury

Orthopedic walking bootOrthopedic boots, also known as removable short leg walking boots, are an effective alternative to casts for various injuries and after surgery of the ankle and foot. Obvious advantages of these boots include ease of application, ability to perform range of motion exercises, and hygienic reasons.

Driving with a boot is not recommended. I have warned many patients that the boot can get entrapped by the accelerator and/or brake pedal. One such episode occurred in Canada. The driver, recovering from foot surgery, collided with a tree and suffered a serious spinal cord injury.

There are no standardized guidelines indicating when a person can resume driving after an injury or surgery. Evaluations such as the brake response time are not perfect estimators of driving ability since there are many more obstacles and distractions on a road compared with a simulation.

The Clinician’s Guide to Assessing and Counseling Older Drivers, 3rd Edition, was published with support from the National Highway Traffic Safety Administration of the U.S. Department of Transportation. (The first two editions were titled The Physician’s Guide…) The main goal of this guide is to help health care practitioners prevent motor vehicle crashes and injury.

If you have think you need a walking boot or other treatment for your foot or ankle, please call our office at (847) 675-3400 or click here.

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