Your foot has been bothering you for quite some time and you have exhausted all non surgical options (physical therapy, orthotics, new shoes, topical pain cream, orthotics) without any relief.
You have decided to have foot surgery... now what do you need to do and need to know???
First - pick a date:
Important questions to not only ask your doctor but consider ...
- how much time do I need off of work?
- limitations as to standing, walking, climbing stairs, shoegear at work?
- can I drive?
- can I cook, clean, exercise and what restrictions are there?
- does my doctor have block time?
- am I having surgery at a surgery center vs hospital?
Second - meet with the surgical coordinator:
Paperwork to be reviewed and completed include a history and physical by your primary care physician stating you are healthy enough for anesthesia. A prescription for bloodwork and an EKG will also be given to clear you for surgery.
The surgical coordinator will also give you a pamphlet from the surgical facility, directions and information on the ice compression machine prescribed by your podiatrist.
The week of surgery:
Your PCP as well as your podiatrist will review which medication must be discontinued the week before surgery which may include aspirin, Tylenol, nsaids, and steroids.
A pre operative appointment will be scheduled in your podiatrist's office to review the surgery in detail, answer all questions and concerns and sign the office's consent paperwork. It is at this appointment that you will also receive a cast boot, prescription for pain medicine, a cast protector and a prescription for an ice compression machine.
The night before surgery:
Review with your PCP the schedule and dosing of your insulin, diabetic medications and hypertension medication.
You are to have no food or drink after midnight the night before your surgical case.
Make sure you have a ride to and from the surgical facility.
The day of:
Wear comfortable clothes.
Get to the surgery center an hour before your case.
Bring your license and insurance cards.
You will meet a number of nurses, an anesthesia team and your podiatrist to sign consent forms and review your specific treatment plan.
You will be walked into the operative suite and greeted by warm faces and blankets. Together your surgeon, the anesthesiologist and nursing staff work together to make your experience as comfortable as possible.
You will awake in a postoperative area. Your foot will be bandaged and elevated with an ice pack placed at your ankle. The dressing is to be kept clean, dry and intact until your next appointment. Pain medication will be waiting for you at your pharmacy. Numbing medicine is given after surgery to aid in pain control and we recommend using the ice machine 30 minutes on and 30 minutes off.
You will be discharged with written post op instructions and will receive a phone call the night of from one of our friendly staff members.
The week after surgery:
You will have your first post operative appointment with your podiatrist which will include X-rays and a dressing change.
At Advanced Podiatry patient care and overall experience is our top priority. We have five foot and ankle surgeons available six days a week to treat you and your family's pedal complaints both medically and surgically.
Mother’s Day is Sunday, May 14, 2017! Let’s take a few moments to discuss women’s foot care. Many moms tend to do all the caretaking and in the process neglect themselves, especially their foot problems! By knowing which conditions your mom- or any other women in your life might be experiencing, you can determine how to best help.
Due to physical activity, improper shoe gear, and pregnancy, there are many conditions that we see often in our female patients (of course we see them in men as well!). These conditions can really affect your feet- some changes may include:
1.Plantar fasciitis: Increased pressure and activity can cause inflammation and tiny tears in the plantar fascia. This can cause a sharp stabbing pain in the heel region. Many women who lead active lifestyles can experience this condition. Why not try Extracorporeal Pulse Activation Treatment (EPAT)? It is FDA approved to treat acute or chronic muscle and tendon pain by stimulating blood circulation and accelerating the healing process.
2.Collapsing arches: The extra weight gain in pregnancy can cause additional pressure on your lower extremities, this can lead to collapse of your arches and then your feet may overpronate (excessive rotation of the feet). This can become a source of ankle, knee, hip and even low back pain! We can fabricate custom orthotics to provide arch support and pain relief.
3.Toe deformities such as bunions and hammertoes which can be treated both conservatively and with surgery. Come into any of our office locations for a surgical consultation.
4.Swelling: can accompany pregnancy (can occur in absence of pregnancy as well!) in which your body produces excess fluid and blood which can accumulate and pool in the feet and ankle.
If you should have concerns with regards to any of these issues, in the spirit of Mother’s Day, or just for your mother’s sacrifices bring her to any of our offices to have her feet and ankles examined at the following locations below:
2110 Northern Blvd, Suite 208 110 East 40th Street, #201
Manhasset, NY New York, NY
(516) 869-3300 (646) 741-7714
181 Main Street, Suite 207
We are more than happy to provide a professional diagnosis and create a customized treatment plan to relieve pain and restore foot function!
Have a very Happy Mother’s Day from the Advanced Podiatry Family!
When it comes to the health of our feet, women are much more vulnerable to ailments than men. One such problem that targets women more than men is Morton's Neuroma (perineural fibroma), which is 10 times more likely to affect woman than men. This painful condition is caused by an enlarged nerve, usually one that runs between the metatarsal heads of the ball of the foot. Morton's neuroma involves a thickening of the tissue around one of the nerves leading to your toes. It is sometimes referred to as an inter-metatarsal neuroma because of its location, which is usually at the ball of the foot between the third and fourth toes. Problems often develop in this area because of two nerves that intersect and become inflamed. These nerves are typically larger in diameter than those going to the other toes, causing the nerve to become enlarged. The thickening, or enlargement, of the nerve that defines a neuroma is the result of compression and irritation of the nerve. This compression creates swelling which eventually leads to a radiating, burning or a shooting type of pain.
There are many factors that contribute to Morton's neuroma, though the condition can arise spontaneously for reasons yet unknown. Flat feet can cause the nerve to be pulled towards the middle of the foot, which can cause irritation and enlargement of the nerve. However, the primary reason women are more often affected by this condition than men, is the same reason for a host of other foot problems that occur mostly in women – poorly fitted shoes. Statistics show that this condition most often afflicts women in their 30s and 40s. Sorry ladies, but wearing the latest 5-inch heels from Jimmy Choo will contribute greatly to this condition. High-heeled shoes cause weight to be transferred towards the front of the foot, increasing pressure on the ball of the foot. Narrow, pointy, and tight-toe boxes create lateral compression, which squeezes bones, ligaments, muscles, and nerves in the forefoot, causing pain and swelling.
Signs and Symptoms:
The pain caused by Morton's neuroma typically develops as an ache in the ball of the foot and progresses to a burning pain. This pain is often described as an intense feeling of pins and needles and a feeling like a pebble stuck inside the ball of the foot. The burning sensation leads to numbness in the second, third and fourth toes. These symptoms begin gradually, with the discomfort occurring when walking, but easing when resting or upon removal of shoes. Some symptoms that indicate Morton's neuroma include: radiating pain from the ball of the foot to the toes, intensifying pain during activity and when wearing shoes, and occasional numbness, discomfort, and tingling. These symptoms may be relieved temporarily by simply massaging the foot or by avoiding extravagant shoes or activities. However, if these instigators are not avoided, symptoms can become progressively worse and may persist for several days to several weeks.
The podiatrist will devise a treatment plan based on the severity and duration of the symptoms. Treatment approaches vary depending on the severity of the problem. Usually, conservative measures are suggested before considering surgery. Some of these treatments include padding, icing, orthotic devices, activity modifications, changes in shoe styles, oral anti-inflammatory medications, and injection therapy.
Better footwear is probably the first and most important step you can take to alleviate this condition. Wearing a shoe with a wide-toe box and a low heel can reduce pain tremendously. Your doctor may also recommend some sort of padding to provide support to the metatarsal arch, thereby reducing the pressure on the nerve when walking. Custom orthotic devices provide the support needed to reduce pressure and compression on the nerve.
Modifying physical activities will also go a long way in reducing the severity of Morton's neuroma. Activities that put repetitive pressure on the neuroma should be avoided until the condition improves. In the meantime, to ease the pain, application of an icepack to the affected area can help reduce swelling. Alternatively, non-steroidal anti-inflammatory drugs, such as ibuprofen, can also help alleviate pain and swelling.
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