Britney Spears Sprains Ankle in Vegas show: OOPS she did it.

Britney Spears Sprained Her Ankle, Fall during Show

#britneyspears

Britney Spears was in the middle of her show at Planet Hollywood in Las Vegas when she sprained her ankle. The pop star was performing her hit song “Crazy” when she twisted her ankle and fell (see image). Surprisingly, she handled it very well and finished the song. She was later advised by her physicians to postpone her succeeding shows for her sprain to heal.

Now wearing a boot, shared on her Instagram:

What is a Sprain?

A sprain is the stretching or tearing of a ligament. A ligament is a fibrous tissue that connects bones, cartilages or hold joints together.

What causes a Sprain?

There are a lot of causes of sprains. Falling, twisting, or any force that can violently place a joint out of its normal position, causing the ligaments to stretch and tear that may lead to a foot sprain.

Signs and symptoms of sprains include pain, swelling and bruising of the affected joint.

Treatment includes:

1. Immobilization and resting of the injured joint. Your physical therapist may require you to use a special boots and crutches.
2. Apply ice for the pain and swelling. You maybe advised to ice the affected area for 20 minutes for around 4 to 6 times a day.
3. Elevating the foot above your heart can prevent pooling of bodily fluids to the foot and can drastically help reduce swelling and pain.

Dr. Kevin K. Lam

Comprehensive Foot & Ankle Care

Post Residency Reconstructive Rearfoot / Ankle Surgery : Fellowship Director

www.NaplesPodiatrist.com

Office: 239 430 FOOT

Fax: 239 692 9436

Blog:  www.DrKevinLam.com

Double Board Certified Podiatric Surgeon

• American Board Of Podiatric Surgery
• Foot Surgery
• Reconstructive RearFoot & Ankle Surgery
• American Board of Lower Extremity Surgeons
• Foot Surgery
• Reconstructive RearFoot & Ankle Surgery

Amniotic Stem Cell Treatment and Knee Arthritis

Dr. Kevin Lam of Naples, FL offers alternative to surgery for knee  arthritis


Arthritis is a general term used to signify inflammation of one or more joints. Typical symptoms include pain, swelling, and stiffness of the affected joint. Arthritis can affect any joint in the body but is notably common in the knee.

Knee arthritis can affect a person lifestyle. The pain associated with knee arthritis makes daily activities difficult, like walking or climbing the stairs. There are many types of arthritis that can affect the knee such as rheumatoid arthritis and post traumatic arthritis, but osteoarthritis is the most common especially among the elderly.

Osteoarthritis of the knee or degenerative osteoarthritis is a condition where the natural smooth lining of the joints which is the cartilage starts to thin out and wears away. This cartilage is very smooth and slippery and it also acts as a shock absorber. Unfortunately, as we age, this joint is susceptible to wear and tear, therefore, thinning the cartilage and exposing the rough bone underneath, which can cause severe debilitating knee pain.

Treatment

Treatments of osteoarthritis affecting the knee focus on controlling joint pain and preventing further damage to the joint. This involves lifestyle modifications such as losing weight, minimizing strenuous activities, dieting, taking medications (pain relievers, steroids) , physical therapy and other remedies. But in worse cases when the pain can no longer be alleviated by conservative means, surgery is recommended like total or partial knee replacement.

Knee replacement involves removing the damage knee and replacing it with metal plates. Unfortunately, the procedure does not guarantee alignment and stability and may require repeat surgery to accommodate this. Also, several complications could occur:

1. Knee stiffness.
2. Wound infection.
3. Infection of the replaced joint.
4. Rejection of the prosthetic joint.
5. Nerve, tendon, ligament or artery damage.
6. Deep vein thrombosis.
7. Persistent pain at the knee.

Amniotic Stem Cell Treatment for Knee Osteoarthritis

Stem cells are unique cells that are capable of changing into different cells. When stem cells are injected into a damaged joint, the cells transform into specialized cells, in this case chondrocytes to produce new cartilage. Also, these cells accelerate the body’s own repair system; hence, decreasing inflammation, promote healing, prevent scaring and improve joint function.

Other advantages include:

1. Amniotic stem cells contain cytokines. Cytokines are signaling molecules that boost the communication of immune response cells and stimulate the migration of these cells toward sites of infection, trauma and inflammation.
2. Amniotic stem cells also contain hyaluronic acid. Hyaluronic acid is a substance naturally found in the human body and like cytokine, hyaluronic acid cures injured tissues faster and promotes bone growth and regeneration of cartilage tissues.
3. Amniotic stem cells do not cause patient rejection and allergic reaction.

www.topstemcell.com

Advantages of Using Stem Cells versus Steroids in Treating Foot and Ankle Pain

Stem cells are special biological cells that have the ability to differentiate to other types of cells and repair or regenerate damaged cells in the body. Due to medical advancement, we can now use the regenerative characteristics of these cells to treat an array of medical conditions, including foot and ankle pathology.

Amniotic stem cells are commonly used in regenerative medicine as it does not cause any moral or ethical issues. These amazing stem cells are considered to be undifferentiated cells, which mean they have the ability to change to different kinds of cells like skin, bone, blood and liver cells. When amniotic stem cells are injected to the affected area, these cells can repair and regenerate the surrounding tissues, able to control pain and swelling, and treat previously incurable conditions. This medical breakthrough is said to be the future of medicine.

Advantages of amniotic stem cell therapy:

1. Amniotic stem cells have the ability to stimulate new tissue growth and repair.
2. The cells contain natural occurring anti-inflammatory agents like cytokines to control pain and swelling.
3. Amniotic stem cells can help promote bone and cartilage regeneration, and could help lubricate the joints because it contains hyaluronic acid.
4. Amniotic stem cells will not induce an immunologic rejection response, patient rejection is extremely rare.
5. Amniotic stem injections are preferred compared to other sources of stem cells like embryonic stem cells or stem cells extracted from the patient’s own blood because amniotic fluid is a highly concentrated source of stem cells.
6. Amniotic stem cell also contain hylauronic acid which is the building block for cartilage and healthy joint fluid. 

How are these harvest? 

Amniotic stem cell donors are prescreened and processed through an FDA approved tissue bank. 

The lab then harvest  the live cells, process them and freeze them in -70C for cryopreservation prior to usage.    Our office obtains the cryopreserved stem cells and place them in our ultra low temp freezer until ready for usage. 

Is it safe?

100% safe. 

Insurance cover? 

No, insurance, medicare does not cover these regenerative treatments. Pro athletes and the elite has used this technology for some time, now made available to the masses? 

Do I qualify?
You must be evaluated by our physicians first. If you are a candidate some procedures can be done the same day or scheduled within 24 hours.  

We have consultant physicians on staff that will do injections above the hip joint for instance, tennis elbow, arthritic thumb, etc. 

Repair naturally, not replace or cover up. 

NOT all amniotic stem cells are the same. 

The pure amniotic stem cell does not involve the chorion layer of the amniotic sac.   This chorion layer has been known to cause inflammation and host reactions.   Company's that offer this cut costs by decreasing the processing and using chorion as a filler material. 

We have had patients that had other amniotic tissue injections to no avail. I prefer to use live stem cells and purest form possible for my patients.    Analogy would be using live bait for fishing or dead cut bait.  If you had the choice which would you choose? 

Comparison to Steroids

Steroids injections provide excellent pain and inflammation control and are generally safe. Unfortunately, there are still potential side effects and disadvantages, especially after chronic use.

1. Temporary relief. Just like other medication, pain and inflammation control provided by steroid use is limited and a repeat injections maybe needed for continued relief.
2. Post injection pain. For some patients, steroid injections can be very painful and may require anesthetic injection.
3. Anaphylactic reaction. An allergic reaction or worse, an anaphylactic shock is probably the most dangerous side effect after joint injection of steroids. This is a life-threatening medical emergency and an experienced medical practitioner should identify the early signs of allergic reaction.
4. Skin changes. For some patients, skin discoloration and atrophy could occur on the injection site, especially with patients who have darker skin.
5. Risk of elevated blood sugar among diabetics. Diabetic patients who undergo steroid treatment should monitor their blood sugar levels.

Dr. Kevin Lam and FFLC offers

Full line of PRP treatments and Amniotic Stem Cell treatments in office.

Naomi Campbell’s Bunions

Naomi Campbell’s Bunions

One of the most recognizable models of the 90s is Naomi Campbell. The English model is also an actress, singer, and author. Having been modeling since the age of seven, she quickly became famous internationally. Even after the end of the supermodel era in 1998, she still continued print modeling.

Having a modeling and acting career means having to constantly wear high pointy shoes. Although there is some uncertainty over the exact cause of bunions, wearing high heels and narrow-toed shoes has always been one of the possible reasons, along with heredity, staying on your feet for prolonged periods, pre-existing foot conditions, and arthritis.

Due to the harm that some models do to their feet, walking and standing for hours in stilettos, some not even the right size, many struggle with hammertoes, plantar fasciitis, Achilles tendinitis, and yes – bunions. Naomi Campbell is no exception.

The worst pair of shoes a woman can wear are pointy ones because these crunch the toes. Combine this with high heels and the result is that the weight of the body gets forced on the toes, resulting in knobby toes, unattractive clawed toes, and bunions. Later on, these foot problems can affect walking and foot pain can become debilitating.

To minimize the odds of getting bunions, never force your feet into shoes that do not fit well. If you already have a bunion, relieve pressure by wearing shoes with enough room. Protective pads may also be worn.

If pain has become unbearable, then you may need surgery. Minimally invasive bunion surgery is a 5mm minimal incision bunionectomy, minimal discomfort, and virtually painless. There is no need to fear the bunion treatment due to pain or scarring. This revolutionary procedure is here and refined at the Family Foot and Leg Center, PA by Dr. Kevin Lam. Call (239) 430-3668 for more information or visit www.scarlessbunion.com

Diabetes Deadlier than Cancer

iabetic Foot Disease Has Higher Death Rate than Most Cancers

Diabetes remains the 7th leading cause of death in the United States in 2010, with 69,071 death certificates listing it as the underlying cause of death, and a total of 234,051 death certificates listing diabetes as an underlying or contributing cause of death¹. One of the common contributing causes of death in diabetes is a diabetic foot ulcer (DFU), and if left untreated could lead to lower extremity amputation (LEA). Five-year mortality rates after new-onset diabetic ulceration have been reported between 43% and 55% and up to 74% for patients with lower-extremity amputation². These rates are higher than those for several types of cancer including prostate, breast, colon, and Hodgkin's disease.

Approximately 15% of all diabetic patients will get a foot ulcer in their life³. Foot ulcers occur due to lack of sensation to the foot. Peripheral neuropathy, another condition commonly found in diabetics, damages the nerves, impairing sensation to the foot. This allows injuries to go unnoticed, leading to infections and ulceration. Diabetic foot ulcers are extremely difficult to treat, and it would take months for the wound to heal and incidence of reoccurrence is high. In the U.S., approximately 67% of all lower extremity amputations occur in diabetics, and approximately 85% are preceded by a foot ulcer⁴.

What to do?

The key in stopping diabetic foot ulcers and possible amputations is to practice proper foot care and to control diabetes.

Foot care regimen:

1. Wash feet regularly. Use a mild antibacterial soap and towel dry.
2. Keep foot dry. Use antiperspirant powder when wearing shoes to keep your feet dry. Excess moisture can soften the skin, making it vulnerable to skin breaks and infections.
3. Moisturize. A foot that is too dry is susceptible to skin cracks, moisturize with your favorite lotion.
4. Cut nails carefully.

Daily Foot inspections:

1. Look for cracks or scratches and treat immediately with an antibiotic ointment.
2. Check for sensation on your foot. If there is decreased sensation than usual, immediately visit your doctor.
3. From time to time, inspect the insides of your shoes if there is a pebble or anything protruding that could injure your foot.

Control Diabetes:

1. Take medications regularly.
2. Go on a diet. Control food consumption to prevent increase in blood sugar levels.
3. Do not miss your doctor’s appointments/check-ups.

1 http://www.diabetes.org/diabetes-basics/statistics/?loc=db-slabnav#sthash.k3SPUfEL.dpuf

2 “Mortality Rates and Diabetic Foot Ulcers” in Journal of the American Podiatric Medical Association, Vol 98, No 6, November/December 2008

3 National Diabetes Data Group: Diabetes in America, Vol. 2. Bethesda, MD, National Institutes of Health 1995 (NIH publ. no. 95-1468)

4 Pecoraro RE, Reiber GE, Burgess EM. Pathways to diabetic limb amputation: basis for prevention. Diabetes Care 1990;13:513--21.

Michelle Yeoh with bad bunions

Michelle Yeoh’s #Bunions and  #Corns

I remember as a child watching Michelle Yeoh doing kung fu movies along side Jackie Chan, etc. She needs a minimally invasive bunionectomy bad before she gets major arthritis in her big toe joint then forget the high heel after a fusion.  Fusion is when the big toe joint or any joint for that matter is locked via plates and screws by a surgeon to limit motion, restore anatomy as well as remove diseased tissue.  

Malaysian-born Chinese actress Michelle Yeoh, popularly known for performing her own stunts in the Hong Kong action films, caused a stir when she was seen with her heavily corned feet at an appearance. Chosen as among the 50 Most Beautiful People in the World in 1997, the Crouching Tiger, Hidden Dragon star is gorgeous, but her feet are another issue, especially those bunions.

Feet constantly stuffed in very tight stilettos may look stylish but can be unforgiving to the toes. Women do love their high heels but wearing them all the time may lead to foot problems and foot pain. The foot conditions associated with these towering shoes include corns, calluses, hammertoes, and the most commonly seen bunion. The condition often gets worse over time but surprisingly, almost half of women admit to wearing a pair of shoes that they liked even if it gave them discomfort.

Michelle Yeoh,as a fan and a foot and ankle surgeon, give my office a call about the minimally invasive bunionectomy:    239 430 3668. 

LeVert Possible Repeat Stress Fracture Injury

LeVert Possible Repeat Stress Fracture Injury

Michigan’s shooting guard Caris LeVert will be sitting it out for the rest of the season due to a foot injury. LeVert was limping after a victorious game against the Northwesterns Wildcats and later that night he was seen on crutches. He is scheduled for surgery this week, following a 12-week and rehabilitation period.

LeVert injured the same foot he had surgery on last May due to a stress fracture, and most likely, he may have the same injury since the recurrence of stress fractures are very high.  

What is a stress fracture?

Stress fractures are small but painful cracks on the bone, usually affecting the foot. This occurs because of muscle fatigue, the over used muscle can no longer absorb shock, thus transferring all the stress to the bone, leading to tiny cracks. Stress fracture is one the most common injuries in sports.   I always refer this to thinking about an egg shell with cracks but not fully broken so that the content does not spill out.    MRI's are excellent at diagnosis this condition, but the advent of ultrasound provides a quick and more cost effective alternative. 

Some patients may have pathological fractures: eg bone tumors or osteoporosis, this needs to be checked thoroughly by a physician. 

Treatment

Rest is the best treatment for stress fractures. Allow the injured bone to heal for 6 to 8 weeks, the patient should not engage in with the activity that caused the fracture during this period. Recurrence of stress fracture is common, which causes larger cracks  or a full fracture that can move out of place and that takes longer to heal and lead to possible surgery.

Another treatment available is injection of stem cells or amniotic stem cells to the fracture site to aid the body in healing of this condition.  This is not covered by insurance but has been proven to cut the healing time in half in fusion cases whereby the surgeon creates a fracture on purpose to allow two bones to mend together.  Fusions are done for generative joint disease and severe deformities such as a collapsed foot or multiple fractures that require stabilization. 

If you have a nonhealing stress fracture or repeat stress fractures see your doctor.