Work place injury

Foot and ankle injuries can be debilitating.   A fall off a ladder, object falling on your feet, or a crush injury can drastically change your life and end your career.   Quick proper care is important. 

Report such injuries to your HR or manager immediately and seek medical attention via urgent care center or ER immediately.    Testing such as xrays, CTs  or MRIs  should be done to find any acute injuries.    Acute meaning recently, as if you get the studies later it may be difficult to delineate what you really injured at work vs a chronic or previous condition.      After the initial evaluation your case worker will assign you to a specialist or clinic for continued care.  

At FFLC we take pride in getting injured workers back to work in a timely manner, with or without surgery. 

BIG Toe pain after Thanksgiving feast

You just may have the GOUT.   What is Gout aka Podagra?    Formerly known as the rich man's disease.   Ben Franklin had it, Kings of England had it.    It is typically an overconsumption of "rich" foods such as red meat, turkey, shellfish, and red wine.    Any overload of protein from any source can bring this about.    

Presentation:
inflammation of the big toe or ankle joint with extreme pain and occurs all of a sudden after a heavy protein meal such as thanksgiving.


Can be confused with:
Cellulitis or an infection, they look the same upon presentation and can be confusing. Sometimes, a physician will give medication for both.


How is it diagnosed?
Blood uric acid levels are inaccurate for acute or immediate attacks.
Joint fluid aspiration aka obtaining fluid from the offending joint via a needle will yield the most accurate diagnosis.

How is it treated?
Cortisone injection
NSAIDS
Fluids
Sometimes medication to control the uric acid
Gout vitamins such as GOUTTROL with natural ingredients to help aid in the inflammation control .

See your podiatrist for this for immediate care and relief.

2015 Year End Deductibles

It’s hard to believe, but 2015 is almost over! Our end of the year appointments are filling up quickly and we at Family Foot & Leg Center would like to remind our patients that now is a great time to think about the health of your feet. If you have met your deductible, now is the time to schedule your appointment and take action towards a healthy pain free life. Your insurance may cover orthotics, , surgery, and more! Take advantage of your insurance plan by calling our office today to schedule your appointment with one of our doctors before it’s too late. If you are unsure if you have met your deductible, we recommend you contact your insurance provider to determine your remaining allowance for this year. We thank you for your patronage in the past and look forward to continuing to provide you with exceptional foot care in 2016!

Health insurance deductibles are your out pocket expenses that must be met before your insurance company starts to pay.  Therefore, if you have had other procedures done this year or your family members on the insurance plan has had some procedures, your deductibles may be met.  
Deductibles have been on the rise year over year, you should check with your insurance company about such.


 Call our office today at 239-430-3668(FOOT) and we will be sure to schedule your next appointment promptly.

#RingWorm skin infection common in #BJJ, #wrestlers and other contact sports.

Ringworm is not really a worm infection at all, it is a form of tinea or fungal infection of the skin.
The infection looks like a ring in nature hence the name, can be raised at the borders.   I have heard of athletes using cigarettes the burn the ringworm out.   Old folkstale cure in the BJJ world possibly but the cigarette burn damages the layer of skin where this fungus lives. In essence killing the fungus as well as its food supply.   Analogy of bulldozing  a house for a roach infestation.     There are safer, less damaging  though less macho ways to treat this infection.


Warm, moist environment such as wet shoes, wet uniforms, wet gym floors / mats from some hard core training can be the culprit, some quick facts

1. can be passed from person to person
2. can be easily treated, usually with topical , over the counter antifungals used for athlete's feet
1. same organism
3. rotate uniforms , shoes, socks so that they have enough time to dry between workouts
4. if over the counter topical care does not resolve the issue, then call your doctor to be assessed and possible oral antifungals may be required or just a stronger cream that is only available via prescription from your doctor

How to avoid

1. rotate shoes , socks and uniforms
2. fully dry your socks, shoes and uniforms prior to wearing.
3. Use a rashguard, my favorite is 

#MRSA aka Methicillin resistant staph aureus infection in #BJJ, #Wrestling + other contact sports, what you want to know

MRSA aka methicillin resistant staph aureus infections are more common nowadays due to previous over use of antibiotics and nature of bacterias to quickly mutate their genes to resist certain antibiotics.    Staph is all over our skin and a natural part of our skin flora or home bacteria, but if there is a cut / rash, the bacteria can enter the body and cause an infection.    If an abscess forms a surgeon would have to perform surgery to drain the abscess and take a culture to assess the bacteria and sensitivity to antibiotics.   Majority of skin infections are still regular staph or MSSA methicillin sensitive, but if high suspicion or history of MRSA then the patient is usually started on one of the anti MRSA drugs vs normal antibiotics.

• Risk factors:
• Previous history of MRSA infection
• Immunocompromised patients such as: HIV, Rheumatoid pts on immunosuppressants
• Increase number of people on the mats over time vs interval of cleaning of the mats with antiMRSA agents.   
• Rolling / training that results in skin abrasions often = more probability for catching and spreading infection. 
• Healthcare workers, corrections officers etc can be carriers of MRSA on their skin and in their nose due to hazards of the job. 
• often we, the doctor, assume MRSA until proven otherwise in this group. 
• Signs of MRSA infection:
• Redness, pain at the site
• Regular antibiotics does not work
• increase in size of redness and swelling
• increase drainage from the site despite antibiotics
• What to DO:
• Go to urgent care or physician ASAP 
• If initial antibiotics are not working please return to the urgent care or physician ASAP
• Must have history of previous antibiotics taken for this particular infection as well as other skin infections in the past
• If after hours , report to nearest emergency room, some of these MRSA can spread fast causing significant tissue injury.   Injured tissue area  great source of food supply for the MRSA  bacteria. 
• Oral antibiotics vs IV antibiotics
• There are some oral antibiotics that works well for MRSA infections. 
• If usual antibiotics don't work a quick workup with a culture or sample of the wound is required to help identify which antibiotic your infection is more sensitive to. Every bug is different in the way it responds to antibiotics
• How to lower your chances
• Clean gym on a regular basis
• Clean uniform required for classes
• Rash Guard with Silver as a part of fabric such the Hyabusa silver rash guards which are my favorites. 
• Silver is a nature antimicrobial and rashguards and prevent rashes and cuts.

Giants player, Daniel Fells infected with MRSA stemming from a a foot & ankle injury

Giants player, Daniel Fells infected with MRSA stemming from a a foot & ankle injury. What is MRSA? 

MRSA stands for Methicillin Resistant Staph Aureus, this is a form of staph aureus that is resistant to most common antibiotics such as penicillins, etc.   In general, bacterias become resistant from exposure to antibiotics in the past or they can obtain a gene through a virus or another bacteria that renders them untouchable by an antibiotic class.  MRSA used to be an uncommon strain during my medical and surgical training with vancomycin IV being the drug of choice.     

Two common subgroups: Hospital acquired or community acquired. 

Treatments for such:

• IV antibiotics like vancomcyin

• Orals such as tetracycline class, bactrim, zyvox, etc. 

• Surgical debridement

• removal of infected tissue and flushing out of infected tissue. 

Identification:

• Done through a culture of the bone, tissue, wound, drainage by your physician

Ways to avoid and treat

• contact sports
• wear rashguards with silver such as hyabusa silver lined rash guards
• wash all wounds with warm water and antibacteria soap
• redness or swelling, see a doctor ASAP
• if on antibiotics and still redness and pain persists see your doctor again or go to urgent care or emergency room

Results if left untreated

• Deep space infections requiring significant surgery
• removal of significant tissue, even amputation by a surgeon
• death in cases whereby the bacteria enters the blood stream

Dr. Kevin Lam

www.NaplesPodiatrist.com

Flesh Eating Bacteria what you need to know now.