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Monday, September 22, 2014

Snow Bird Season in #SWFL starts October

It is that time again where our northern friends return to enjoy our beautiful weather.   A few tips, when you are driving down, please make several stops and walk around to prevent deep venous thrombosis or clotting of the veins that can be deadly if progresses to the lungs.
Symptoms are redness, swelling, warmth of usually one let.  Present to the nearest emergency room immediately to get checked.  Any medical treatments and surgeries done up north, please bring a copy with you to your doctors here in SWFL.
Make sure that if you have had any address , insurance company changes, you let your doctor's offices here know about such.

Welcome back, enjoy our weather and hospitality.  If any of our patients requires a referral to a generalist or another specialist, please feel free to contact your FFLC doctor as we have a wide network  and have the inside information for your safety.

We have 3 offices to service your needs:
661 Goodlette Road, Suite 103
Naples, FL  34102

12250 Tamiami Trail East, Suite 101
Napes, FL 34113

1661 Medical BLVD, Suite 302
Naples, FL 34110

Central Scheduling:
Call: 239 430 3668
Fax: 239 692 9436

Jon Bon Jovi has heel pain relieved with endoscopic release

For the past three decades, Jon Bon Jovi has been performing concerts all over the world in front of millions of loyal fans. What those fans did not realize was that he was pushing through intense foot pain for many of those concerts. “The pain was so severe during my 2013 Because We Can Tour that I would want to jump through the ceiling whenever it was touched,” Jon says. “I got to the point where I was given injection therapy, orthotics, shockwave therapy, and platelet rich plasma (PRP) therapy, but they did not alleviate the chronic condition.” After the tour concluded, Jon revisited John Connors, DPM, a sports podiatrist at Riverview Medical Center.


Jon Bon Jovi and Dr. John Connors


At Riverview, under the care of Dr. Connors, Jon underwent endoscopic plantar fasciotomy (EPF), which is a minimally invasive and minimally traumatic surgical treatment for chronic plantar fasciitis. Six weeks is the typical recovery time for this surgery. “Exactly six weeks later, Jon was again walking and jogging on the treadmill,” Dr. Connors added. “He is now 100 percent for the first time in years.”

Source: Robert Cavanaugh, Meridian Health Views [September/October 2014]

From Dr. Kevin Lam:
EPF is a procedure using small stab incisions and a 4mm camera used to visualize the plantar fascia then a blade is inserted from the opposite side to cut the fascia to relieve the pain. FFLC has this and newer technology for those nagging heel pains.

Wednesday, September 10, 2014

Back Pack Tips for Back to School

September 17th is National School Backpack Awareness Day



The kids are back in school and toting around those ever–present backpacks crammed with books, notebooks, electronics and lunch. But all too often a backpack can weigh 12–15 pounds, which can be too heavy for a child’s frame to carry.

A too–heavy backpack can lead to poor posture and back pain and injuries, such as:


  • Stress fractures
  • Inflammation of growth cartilage
  • Back and neck strain
  • Nerve damage in neck and shoulders
  • Low back pain


Look at it this way – carrying a 12–pound backpack to and from school and lifting it ten times a day for a school year puts a cumulative load on a child’s body of 21,600 pounds – the weight of 6 mid–sized cars!

Carrying a backpack that is too big or heavy also changes the way kids walk, putting them off balance. This increases the risk of falling, especially on stairs, and can cause foot and ankle injuries like torn ligaments and sprains.

Visit the American Occupational Therapy Association (AOTA) website for information on this year’s National School Backpack Awareness Day on September 17th. You’ll find helpful information on injury risk factors and strategies for choosing and loading a backpack properly. Here are a few examples:


  • A child’s backpack should weigh no more than 10% of his or her weight.
  • Choose a pack that ends above the waist and that has padded, adjustable straps; always wear both straps.
  • Carry only what is necessary.
  • Consider a backpack that has rolling wheels if permitted in your child’s school.

Monday, September 8, 2014

Joan Rivers and outpatient surgery environment, shouldn't be done?

The death of a comedic icon, Joan Rivers is unfortunate and has shed a spotlight on the topic surgical settings. 

Reality is that mortality, death, can happen even in the most minor of procedures either in the hospital , office based surgery or the ambulatory surgery outpatient setting.    The regulations in place for all outpatient surgery requiring anesthetics of any kind that is more than local anesthesia (commonly referred to as novacaine)  is very strict by various state laws.  

Due to insurance and government's efforts to control costs more procedures are going outpatient to the latter two of the facilities.   Cost savings are enormous for the government, insurance carriers and to patients.   
Hospitals usually charge and receive up to 3 times the reimbursement for the same procedures done at outpatient facilities while doctors are paid similar regardless of facilities chosen. 
The question that was brought up recently was safety, is it safe? 

Yes, the outpatient facilities are just as safe as hospitals and are under tighter scrutiny, just ask the administrators of those outpatient facilities.   If sedation or general anesthetics are used the surgeon as well as the anesthesiologist are both required to be certified by American Heart Association in Advanced Cardiac Life Support.     The same doctors responsible for life saving actions in the hospitals are present during outpatient surgeries as well as same drugs. 

The media seems to spin things out of proportion for ratings.    The outpatient facilities tend to deal with cleaner cases which also tends to lower infection rates vs hospital setting.  This is a big plus for patients.    Hospital acquired infections are less common in the outpatient setting as there are no long term patients undergoing dirty procedures such as a perforated bowel, MRSA wound washouts, etc.

The other topic being brought up is should an 81 year old have elective surgery?    Some 40 year olds I've seen are in worse shape health wise then my 85 year olds that walk 5 miles a day etc.    Age is nothing but a number is correct,  the health age is more important.   Just because a person is over 65 does not mean they are over the hill for elective surgeries.  For myself as a podiatrist, most of what I do is elective such as bunions, hammertoes, fusions, ankle arthroscopies, as long as the patient is healthy enough and active risk of anesthesia death is relatively low.