Those Pesky Ingrown Nails

Have you ever had pain along the borders of your toenail on one of your toes? There is a condition known as in-grown toenails. Many of us have heard about them because it is such a common condition. Due to pressure from tight shoes, improperly trimmed toenails, certain foot types that put pressure on the toe nail or genetic components, in-grown nails can develop.

Ingrown toenails are a common condition in children. For children that have ingrown toenails due to improper trimming, this can be a simple fix. Toe nails are meant to be trimmed straight across as opposed to fingernails that are trimmed in a semicircle. This prevents edges that can grow underneath the folds of your toenail. Teaching your child how to trim their toenails can keep this condition from occurring. Another simple fix is if your shoes are too tight, you can be measured for properly fitting shoes by your podiatrist and get you in your proper width and length. Shoe type and genetics are more difficult to correct, especially genetics. In these two conditions, there are several ways to correct the condition.

One way is to trim the corner of the nail if the nail is not significantly ingrown. Another way is to remove a sliver of the nail. This can be done under a local anesthesia injection The procedure can be done in the office and is a very quick procedure. It can be done one of two ways, either with a temporary or permanent removal. The permanent removal can be done if the condition continues to occur. There is a chance, although slim, that the nail could become ingrown again.

Once the section of nail has been removed, it will be wrapped with Neosporin and gauze to prevent infection. You will need to come back to the hospital within about a week so that the toe can be examined to check for any drainage or infection.

If the toe is infected before the nail is removed, the infection may need to be treated before the nail section can be removed. This will be dependent upon the severity of the infection. If you live in the North Andover, Methuen, Boston, Lowell or Bradford Massachusetts and you have this condition, our office staff would be more than happy to schedule you for an appointment and help you get back up on your feet.

Diabetic Foot: Neuropathy

Diabetes is a condition that affects the entire person. Your entire body is dependent on glucose to provide your system with the necessary energy to make it work. However, when insulin is not functioning in your body, this energy cannot be processed and used from your food. When blood sugar levels are high, it can lead to conditions such as neuropathy from nerve damage.

Neuropathy is a condition that causes tingling and eventually numbness in your feet and legs. This can be a very scary feeling for someone because you no longer can feel what is touching your feet. This can lead to ulcers forming as a result of a rock or any extra item getting inside of your shoe. For most people, when something gets inside of your shoe, you can feel it, remove it and move on, but for a neuropathic person, they can’t feel the item in their shoe and will continue to walk around with it and potentially causing a great deal of damage.

The most beneficial thing a neuropathic patient can do is look at their feet. At simple as this may seem, looking at your feet to see if there are any sores or open wounds on your feet. It is also important to look at the bottom of your feet. Standing and looking down at the top of your feet is not enough, a full visual exam is important, in order to be proactive and prevent ulcers from progressing to the point of infection that would require amputation.

It is also important to see your podiatrist on a regular basis. The podiatrist will be able to monitor the changes in your diabetes and inform you of any new precautions you need to be taking. If an ulcer does occur that you notice during your visual exam or that the podiatrist sees will need to be aggressively treated. There are several different ways that an ulcer can be treated including off-loading the area to decrease pressure on the ulcer, debriding an ulcer to remove the dead skin to promote healing, cleaning the wound and possibly using a skin graft to promote healing.

Diabetic ulcers are a condition that should be taken very seriously. If you live in the North Andover, Methuen, Bradford, Lowell or Boston Massachusetts area and you have diabetic neuropathy, our office staff would be happy to help you set up an appointment to see Dr. Wachtel. After your initial visit, an individualized plan can be made to help you be successful with your diabetes.  

Running Shoes

With the weather telling us that it is time to get outdoors, what better time is there to start that new running plan? Before you set out to hit the pavement, trails or the gym, here are a few things you should know about your running shoes.

During a normal walking gait, you have a double stance phase which means that there is a moment when both of your feet are on the ground supporting your body. During running though, you have a double swing phase which means there is a time when both of your feet are off of the ground. When neither of your feet are on the ground, there is a greater amount of impact that your feet must undertake to absorb the force subjected to your feet. This is one of the reasons it is so important for you to have good quality shoes that allow you a great deal of cushion. It is also why you need to watch your shoes for any signs of wearing, since these indicates point to your feet no longer being as protected from the forces as they were before.

A good rule of thumb is 300-400 miles for a pair of shoes. This is easier to keep track of for runners who have a definite routine, but for many of us this is not something that we readily know. Some suggestions are writing the date that you buy the shoes on the bottom of them and then guesstimate about 6 months to a year unless you run much more than that. Another way to gauge when you need to buy new shoes is if you start to feel abnormal amounts of muscle pain, shin splints or an unusual amount of tiredness after a run that is pretty normal for you. These can be a good indicate that it is time for a new pair of shoes. However, if these conditions don’t improve even after switching your shoes it is time for you to seek medical care to determine if there is an underlying condition.

In Dr. Wachtel’s office, there is a shoe store that sells a wide variety of shoes that are great for different foot types and for running. They are sold in different sizes and widths to accommodate many different foot types. There are pictures of these shoes that can be found at this link online, just click on any of the brands to see the available shoes. If you live in the North Andover, Methuen, Boston, Lowell or Bradford Massachusetts area, feel free to call the office and make an appointment and our office staff can get you fitted and order shoes for you so you can get out and enjoy the spring weather.

March Featured Product: Gel Dry Skin Therapy Socks

It feels like winter has come and gone, but that doesn’t mean that the plague of dry skin has left. For many people, the colder and drier winter months bring cracking, flaking, itchy dry skin, but for some people this unfortunately doesn’t go away with the arrival of spring. Sometimes, this is a result of aging, poor circulation as a result of diabetes or it can even be that your skin doesn’t produce as much hydration. Regardless of the cause, it can be very frustrating to constantly be dealing with the lotions, creams and variety of many other suggestions for your skin that can end up just leaving a mess. So, if you find yourself to be in this boat, the product of the month for March just might be your life saver.

Gel Dry Skin Therapy Socks are socks that time release a mineral oil onto your feet leaving them moisturized while avoiding the mess of lotions and creams. The socks will last for up to a 3 month time period dependent upon how often you are using them. They can be washed just like your other socks are. An added perk for these socks is that although they have a cinched top to them, they do not cut off your circulation like many other tube socks would. This serves as an additional benefit especially for diabetic patients in whom it is so important to keep blood circulation as strong as possible.

Another perk is that the gel being released from these socks is both hypoallergenic and it will not serve as a pool for bacteria to grow in. So, if you are having trouble with dry feet or ankles, you can head over to the following link: http://www.ourdoctorstore.com/wachtel/store/item.asp?ITEM_ID=272&DEPARTMENT_ID=54, and give these socks a try. Hope this helps with all of your dry skin troubles!

Thick, Yellow, Fungus Nails: The Solution

Spring is in the air! This means it is time for picnics, going to the park, laying out reading a book and breaking out those sandals and flip flops. Unfortunately, not everyone is proud of their little piggies and some people try to cover them up. This is often because of thick, yellow, fungus nails that we are ashamed to show the world. But, no need to worry; we’ve got the cure from you.

Laser therapy is a technological advancement that allows specific wavelengths to be used that promote growth and repair of the nail while killing the fungus. It is a non-invasive procedure and the most that a patient will feel is a bit of warmth from the laser beam. The laser therapy stimulate growth and healing by increasing the circulation to the affected area, your toenails. This increased circulation allows your body to bring the necessary healing cells within your body to the site. This then allows your body to repair itself leaving you with those gorgeous toenails you want to show off to the world. 

The laser functions to heat up the fungus and kill it directly. This is different than other creams, formulas or even oral medications that you have tried because it is working directly on the fungus as opposed to treating an area or the entire system. This explains why people who have tried an entire medicine cabinet’s worth of products and have not had success will see a difference with the laser treatment.

The nail requires 2-3 months of treatment before you will see results. Additionally, the entire nail takes about 6-8 months to completely be replaced. Therefore, this is a slow process, but it was one that will leave your nails looking better than ever.

The only current contraindications to this treatment are pregnant women and if there is a tumor within this area. Other than that, the procedure is harmless. So, there is no reason that you should not get your feet back out into the world. This is the perfect time of year to do it, because you will start seeing results by the time you are ready to hit the beach.

If you live in the North Andover, Methuen, Boston, Wilmington or Billerica Massachusetts and you are dealing with thick, yellow, fungus nails, our staff would be more than happy to help you decide on the best plan for you.

Stretch it out! Plantar Fasciitis Exercises

If there is pain on the bottom of your foot by your heel, which radiates up your leg, it may be due to plantar fasciitis. This condition is a result of the tissue on the bottom of your foot (plantar fascia) being stretched repeatedly and sustaining micro tears occurring within the tissue. These tears start out very tiny, but they become inflamed and very painful. It is possible for the plantar fascia to tear in two if it is not treated properly. Plantar Fasciitis is a very common condition that many Americans will deal with at some point throughout their life.

There are several treatment plants for plantar fasciitis including cortisone shots, exercises, padding, laser therapy and surgery. For many people though, exercises are the best option to try initially because it is non-invasive. Listed below are some of the exercises that can be used for strengthening the fascia.

1)      While sitting in a chair take your foot in the air and flex it up towards your body and down towards the floor 12 times.

2)      While you are sitting watching a movie or reading the newspaper, you can take a tennis ball and roll in back and forth under the arch of your foot.

These exercises will help to relieve the pain of your fascia. However, it is important that you also be fitted for the appropriate orthoses. The condition is often a result of flat feet or obesity causing collapse of the foot. Orthoses will help to hold your arch in place preventing the fascia from being stretched over time. It is also important that you do not walk around barefoot because there is no structure being provided that prevents your foot from flattening out. The lack of support for your foot will allow it to flatten out even more putting increased stress on your fascia.

Through these exercises, you will be able to relieve the pain you have been experiencing and in combination with other treatments, you will be able to prevent surgery. In no time, you will be back up on your feet and ready to go!

If you are in the North Andover, Methuen, Boston, Lawrence or North Reading area, and you are dealing with this condition, or any other foot condition, please feel free to contact us and our staff will be more than happy to assist you.

All of those aches and pains: Rheumatoid Arthritis

Do you suffer from pain in your joints? You may be dealing with a condition called rheumatoid arthritis. This disease starts in the smaller joints of both your hands and feet and will progress to include other larger joints throughout your body. Rheumatoid arthritis is a symmetrical condition though, which means that if it affects one hand, then it will also affect the other hand. This condition has a greater prevalence in females; however, it does also affect men. It often starts anywhere from the early 20s through the 60s. People will experience pain, swelling and stiffness in these joints and will notice that they are very stiff especially in the morning.

Rheumatoid Arthritis is a condition that can lead to deformities and lack of motion in the joints as a result of joint inflammation and breakdown. Unfortunately it is not a condition that has a cure and so it involves a life-long relationship with your primary care provider helping to alleviate symptoms as they occur. This may involve resting the joints so that they are not over worked, however, you do not want to completely stop moving because that will only cause your joints to freeze up. Instead, you want to start doing low impact exercises such as swimming and biking that do not put an excessive amount of weight onto your joints. You can also use pain killers to help relieve the pain and orthoses can be used to help correct the foot placement and prevent joint breakdown.

Many people at some point will have to undergo surgery to either replace their joints or fuse them to minimize pain and discomfort.  These surgeries are not right for every patient and you must be evaluated to see which option will be the best for you. Rheumatoid Arthritis is a very individual disease that affects everyone in different ways and at different rates. It is important to remember that this is a lifelong condition, but it is one that has been making great progress in the medical research field. There are new forms of surgery, bracing and medication that are being developed to yield you the best results possible.

One of the most important things that you can do is form a good relationship with your podiatrist. That way, each time you develop a new symptom or condition, it can be dealt with promptly yielding you the best treatment and results. If you live in the North Andover, Boston, Methuen,Wilmington or Newburyport, Massachusetts area, our office staff would be more than happy to assist you with all of your podiatric healthcare needs.  

Is There Pain Between Your Fourth and Fifth Toes?

Have you ever experienced a sharp pain between your 4^th and 5^th toe? This may be due to a condition known as Heloma Molle or more commonly called “kissing corns.” This occurs when there is a corn on your 4^th toe that is rubbing against a corn on your 5^th toe. Since you have nerve endings in this location on your toes, it can cause pain in your web space. This pain can be debilitating and cause you to limp and favor your foot to try and prevent your pain. Heloma molles can occur in between any of the toes but it is most common between the 4th and 5th toes.

A heloma molle can result from one of the bones in your toe being wider than the others. Most toe bones are wider at their ends and tapered in the middle. In some people with heloma molles the ends of their toe bones will be wider than typical. This is what causes the additional pressure on your toe forming the heloma molle. It is also possible though that you can have completely normal toe bones and still get a heloma molle. If they continue to recur, a X-Ray can be taken to find out what shape your toe bones are. When a lot of people think of corns, they think of hard corns, but a heloma molle is a soft corn. It just looks like a change in the pigment of your skin.

There are several forms of treatment for heloma molles, including conservative and surgical treatment. The conservative treatment involves your podiatrist using a blade to shave off the corn. This procedure is done without any numbing of your toe, because it is a virtually painless procedure. Once this is done, a small wedge can be put in between your toes to separate them and try to prevent the toes from rubbing and forming the corns again. Wider shoes can also be considered to prevent your toes from rubbing together and causing the friction that results in these corns. The surgical treatment of this condition involves shaving down the bones to make them not as wide. It is a very low intensity surgery that you will recover from quickly. If the heloma molles continue to occur, this surgery can be considered as a treatment plan.

If you live in the North Andover, Lowell, Methuen, Bradford or Boston Massachusetts and have any of these symptoms, our staff would be more than  happy to help relieve your pain and treat your condition.