This seems kind of like a funny question because how are you supposed to get around when you cannot walk is a typical question I get from a lot of patients. There are a few reasons why I ask my patients not to walk, or rather not to put pressure on their foot. If you just had foot surgery, you should not be putting pressure on your foot and you should not be having your foot down because the more you have your foot down and pressure on it, the greater swelling you are going to have, the greater pain you are going to have, and as well, the greater risk of having a complication to the surgery, at least until the bone is healed or the skin is healed, depending on the type of surgery. But as well, you could need to stay off of your foot because you have a sore on your foot. This is typically from someone who has diabetes or a foot ulcer on the bottom of their foot or on any part of their foot and I ask people to stay off of their foot and the way you stay off of it with this is to use either a knee walker. One company that makes them is a company called Drive and they actually have a cup holder that you can put a soda in there if you want. Probably should not be having soda though! Another option is using something called a Freedom Leg. This is actually something that you put on your thigh and on your leg and it allows you to walk, but it transfers all of the pressure, instead of to your foot, it transfers it to your leg so your foot is not actually put on the ground. It works very effective. If you still need to get around and are unable to do any of these knee walkers or the Freedom Leg, an okay option is to try to use crutches, a cane, or a special walking boot that can take the pressure off of the area. All of those other options are not optimal, but they work okay. If you want to see what you can expect before, during and after surgery click HERE.
There are basically three steps to trim your toenails properly. The first thing you need to do is get the proper instruments. Most people have the typical nail nippers that push down between your fingers and it cuts the toenails. These are okay for normal-looking, normal-thickness nails, but if you have a thicker nail with a nail fungus, you should get the heavy duty nail trimmers that are used kind of like scissors. Be careful, especially if you have diabetes or any other conditions, or you have a lack of sensation or lack of blood flow. When you are trimming the nails, try to trim them straight across. I do not recommend trimming into the edges if you are trimming them on your own. A lot of the reason I see people with ingrown toenails is because they are constantly having to trim out the edges. If you are trying to trim out the edges, or if you feel like you have to, it is usually because you have an ingrown toenail and you should see a podiatrist. The third thing is if you are trimming your toenails and you find that it is painful on the edge, if you cannot get out the edge, if it looks red, infected, or swollen, you should probably see a podiatrist and get some help. So, those are the three tips on how to trim your own toenails. If you want to learn more about how to treat ingrown toenails click HERE.
Kerasal is a type of a urea cream that can be used on toenails. Many people have tried different types of home remedies, such as tea tree oil or Vicks VapoRub. One other type of treatment is a urea cream that can be bought over the counter, called Kerasal, or even in the doctor's office something called Calicylic cream. These are 20 to 30% urea-based creams and they can be used on toenails to reduce the thickness and have them make them easier for you to trim. They do not always clear up the fungus (actually, they very rarely clear up the fungus), but they can make them a little more manageable and easier for you to trim. These types of creams can also be used on calluses on the bottom of the foot or on areas that become painful because of callusing. To learn about other ways to help nail fungus click HERE.
Acid treatment is one of the treatments that causes the most problems we see in the office. Many people try to treat their calluses and their warts with acid and they either get too strong of an acid, or they put it on too long and this can cause a sore on the bottom of the foot. This sore is typically called an ulcer and it is caused by having too much acid for a prolonged period of time. Some of the more common ones that you may find over the counter are Compound W or Salinocaine. These can be both purchased and tried over the counter. There are also some over-the-counter remedies for both ingrown toenails and calluses that if you look at the components, they have a component of something called salicylic acid. All of these are acids and they can injure the skin. The problem is they do not know when to stop and so if you keep putting it on, it can break down the top of the skin, which is called the epidermis, and go down into the dermis, which is the area that is the beefy, red area of the skin. I had one patient, he was a man and he thought he had a wart on his heel and he used an acid for many weeks and he came in with a very large wound on his heel and he could not even walk. He was on crutches. We did not need to do much treatment to heal it, all we had to do was have him stop using the acid and it healed up on its own. You can imagine for a healthy young man, that is easy, but if someone, for example, has poor blood flow or poor feeling in their feet, it can create a big problem for them.
Many patients come into the office because they want to know how to treat their toenail fungus. I typically give them three options for treatment. We can use a topical medication, which I typically use Formula 3 and it offers about 20 to 30% success rate. Another type of treatment is an oral pill called Lamisil, but many people do not want to take it because they are concerned about the complications with the liver and so they choose to do laser treatments for the toenail fungus. These consist of typically three treatments. They are spaced out at one month, three months, and then as needed. I find that typically three treatments are enough, but occasionally we have to do a fourth or a fifth. I find both the oral pills and, as well, the laser treatment to be about 80% effective for treating toenail fungus.
If you are interested in learning more about getting toenail treatment for nail fungus, you can visit our office or even research online about laser treatment for toenail fungus. Here are some resources I recommend - click here.
Many of my patients in the area of Worcester ask what type of shoe stores we recommend as podiatrists. On my blog, www.drpelto.com, there is a list of shoe stores that I typically recommend and I am going to go over a few of them with you.
First of all, I recommend a shoe store called Sneakerama. Sneakerama is a place where you can buy sneakers and athletic shoes and they do a very good job, especially finding shoes that can fit orthotics in them.
The next shoe store is Panza Shoes. It is located in Framingham. They have shoes that are more for professional females and males for hard-to-fit feet. If you go to their website prior to seeing them, www.PanzaShoe.com, you can get a coupon to get a discount on your first pair of shoes.
Evans on the Commons is located in Townsend, Massachusetts. They have a good selection of shoes, as well as the Walking Company at the Solomon Pond Mall, they have a good selection of shoes, and then there are also different types of shoes that can be found online and you can find a complete list on the website.
If you have a need for diabetic shoes though, we can actually offer them through our office to help for people who have high-risk feet of developing sores, wounds, or other types of complications.