Posts for: April, 2020

By Dr Shabana Chowdhury
April 21, 2020
Category: Foot Care
When trying to rule out the possibility of having COVID-19 we check for high fevers, muscle pain, headache and even loss of smell. However, new reports of COVID-19 cases are showing that patients are also developing “black and blue” type lesions in their hands and feet. The lesions seem blister like and many patients might confuse them for traumatic lesions if they aren't showing any other signs of COVID-19. These acute acro-ischemic lesions could be the expression of secondary microthrombosis due to endothelial damage and vascular disorders.
 
This reports the association between coagulation disorders and acro-ischemia manifesting with cyanosis, blisters and gangrene of fingers and toes in severe cases of COVID-19. Some patients with COVID-19 are also showing erythematous rash, urticaria or varicelliform
exanthema. However, it is not uncommon for these dermatological manifestations to come about with other viral infections.
 
The Centers of Disease Control and Prevention has not listed any kind of skin irregularity as a coronavirus symptom yet. However, as more patients test positive we are learning more about this disease. If further observations and laboratory data will confirm that we are facing a clinical sign of COVID-19, this dermatological sign could be useful for identifying children and adolescents with minimal forms of infection, but potential sources of further infection.

By Dr Arden Smith
April 20, 2020
Category: Others
                                
 
At this present time, with COVID-19 in our life, walking for exercise as a physical activity is the best choice for now. It is also good for a decrease in anxiety, depression, as well as many other benefits. When we exercise, we release the body's endorphins which are chemicals that are produced naturally by the nervous system to cope with pain, stress, and depression. They are referred to as "feeling good chemicals" as they can act as a happiness booster and pain reliever.
 
Unlike jogging, there are fewer injuries to the feet, ankles, knees, hips, and lower back with walking. Many walk for their own benefits and others are walking for charitable causes. The potential benefits to a regular walking program include lower blood pressure, reduction in stress and arthritic pain, and an improvement in circulation.
 
In our present unusual time of the COVID 19 Pandemic, it just plain gets you out of the house. Remember social distancing and wearing a mask unless you are walking in a sparsely populated area.
 
As with any new exercise program, remember to break in slowly to avoid over-use problems. If any issues do arise, our expert podiatrists are always here for you at Advanced Podiatry of Manhasset, Huntington, Plainview, and Maspeth.

By Dr Arden Smith
April 13, 2020
Category: Others
     Dr. David Ehrlich     Dr. David Cheskis

 

Our two youngest and most junior associates, Dr. David Ehrlich, Chief Resident at Metropolitan Hospital and Dr. David Cheskis,  Chief Resident at the NYU Langone Hospitals, who are both in the process of completing their residency in "Reconstructive Foot Surgery and Limb Salvage of the High Risk Diabetic Foot;" and will be joining us in the offices of Advanced Podiatry on July 1, 2020, are at this time completely devoted to the management of COVID-19 patients at their respective hospitals. Our new young associates, are already well integrated into the general surgery and medicine services and have been completely enlisted to the care of COVID-19 and other critically ill patients at their respective hospitals. These resident doctors, Dr. Erlich and Dr. Cheskis are working long shifts screening patients in the emergency department, working the ICU, and providing telemedicine consultations while continuing to manage a steady stream of lower extremity pathology, trauma, and infection, often in patients who are already quite ill with COVID-19.
 
All of us, professional and support staff, at Advanced Podiatry of Manhasset, Huntington, Maspeth, and Plainview have our hats off to them and can't wait for them to join us in the office.

By Dr Tyler Miranda
April 01, 2020
Category: Ingrown Toenails
Tags: Ingrown Toenails  
                              
 
What is an ingrown toenail?
An ingrowing toenail when the nail plate itself curves down towards the soft tissue on the side of the toe. This position of the nail causes the nail plate to press on the skin and sometimes the nail can pierce the skin and the soft tissue. This can cause pain and soreness that can feel sharp and throbbing. An ingrowing toenail is at high risk for becoming infected and these conditions should be identified and treated promptly.
 
How do toenails become ingrown?
There are many reasons that a person gets an ingrowing nail. 
The anatomy of the foot and the toe are a large factor. A wide nail plate, a naturally curved nail plate, an enlargement of soft tissue at the nail borders, or an abnormality in the shape of the bone beneath the nail plate can all contribute to a patient getting an ingrown toenail. 
 
Poor cutting technique at home or in a nail salon
Poor shoe choices including ill-fitting shoes that are too short or too narrow
Trauma to the nail can change the trajectory of nail growth or cause alteration to the structure of the nail plate itself
Fungus can cause nails to become thick, brittle, weak, and generally abnormal which can each lead to an ingrowing nail.
 
Biomechanical problems are a major and frequently overlooked cause of ingrowing nails. Bunions and abnormal angles of toes and bones are a major factor when it comes to how the toe takes the pressure and if the nail will sustain abnormal forces that can lead to an ingrowing nail. Limited or complete loss of range of motion at the big toe joint can also cause abnormal pressures resulting in an incurvated nail. More general structural foot problems like flat feet, excess, pronation and collapsing arches are all significant factors that can determine if one is prone to ingrowing nails.
 
How can I treat an ingrown toenail?
 
The internet is crowded with suggested home remedies for ingrowing nails but the fact is that most of these ideas can make a situation worse.
 
Fist contact a podiatrist and left them to evaluate the toe to determine the proper course of treatment.
 
One your doctor evaluates you and the ingrowing toenail they will determine which of the treatment options are right for you. Your doctor may recommend a clip out of the offending portion of the nail plate, temporary removal of the incurvated portion of the nail plate, or permanent removal of the part of the nail that is causing the issue. If an infection is present the infected tissue and fluid can be removed and drained at this time. Your doctor will discuss these options and recommend the proper treatment for you as an individual. 
The vast majority of these treatments are quickly performed in the office and allow you to leave in normal shoes able to perform the normal activity. Any restrictions on activity will be based on specific treatments. Caring for the site after is easy and usually requires a basic band-aid dressing for a few days. If your toe was infected your doctor may advised you to apply antibiotic ointment on the site and or prescribe you a course of oral antibiotics.
 
How can I prevent getting an ingrown toenail?
Ensure proper cutting techniques. Cut the nails straight across, not down the sides. Don't allow the nail salon to cut too short or too deeply and do not allow any technique that causes pain or damage to the soft tissue around the nail.
 
Wear shoes that fit appropriately. If your shoes come to a point or are too narrow or short then they may need to be donated in exchange for something that appropriately accommodates your foot type.
 
Address underlying issues.
 
If you have fungal nails treat them. Your doctor can discuss with you the options of debridement, topical medication, oral medication, and laser therapy. 
 
If you have a structural abnormality like pronation, flat feet, or bunions, be sure to manage them with the appropriate treatment. Your doctor can advised you on the best course of action, whether it be conservative splinting and shoe modification, surgical correction, or simply a custom made orthotic to optimize your foot structure and mechanics. 
 
The take-home point here is that if you have pain in the toe get it looked at. Don't try to self treat it. At Advanced Podiatry, we are happy to discuss your issue, how it came about, how to treat it, and how to make sure you are walking pain-free as soon as possible. If you need anything or have any questions please give us a call. Our 10 doctors are all available to discuss your issue and we can even do the appointment virtually or over the phone to get things started! 
 
Stay safe, be well.



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Advanced Podiatry of Manhasset at the Americana

Manhasset, NY Office
Advanced Podiatry
2110 Northern Blvd.
Suite-208
Manhasset, NY 11030
(516) 869-3300

Huntington, NY Office
Advanced Podiatry
181 Main St.
Suite-207
Huntington, NY 11743
(631) 427-3678

Coram, NY Office
Advanced Podiatry
100 Middle Country Rd.
Coram, NY 11727
(631) 696-9636

Plainview, NY Office
Advanced Podiatry
875 Old Country Rd
Plainview, NY 11803
(516) 681-8866

Maspeth, NY  Office
Advanced Podiatry
70-01 Grand Ave
Maspeth, NY 11378
(718) 639-0499