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Tuesday, November 10, 2015

Marine Corps boot camp + sprained ankle = Zimmermann Podiatry

"Why on earth did you chose to become a podiatrist?"

For every person that ever became a podiatrist, this question comes as no stranger. On a near-daily basis, I have been asked the same question for 18 years. The question usually comes as I am diagnosing a toenail ripe with fungus. It's a fair question at that point.

For all those that are curious as to my answer, here you go. In honor of the Marine Corps birthday, you get the truth, even if you can't handle the truth!

The time and place: 1988, USMRCD San Diego; Marine Corps boot camp.

I am busy running in my platoon's initial physical evaluation, doing a 3 mile run around a dirt track that sits directly across from San Diego International Airport, separated only by a chain link fence. With less than one hundred yards to go, my left foot lands on a rock and my ankle rolls and makes a loud popping noise. I fall to the dirt like a sniper has taken me out. I grab my ankle and curse and wait for the paramedics to come take me away on a stretcher. Instead, several nice drill instructors run to me and bark in my face and call me horrible names and 'encourage' me to get up and finish the run. I do not bother wiping the spit off my face and limp at a high rate of speed over the finish line, a gaggle of agitated drill instructors in tow, yelling obscenities at me and saying horrible things about my weak ankles.

Later that day.

"What the is that on your ankle, freak!?!" Yells my senior drill instructor as he points at my ankle, seeing it for the first time outside of a boot.
"Sir, this recruit sprained his ankle." I respond.
"No, doubt Sherlock." He replies, wincing in hatred at the mere sight of my weak ankle. "Can you train?"
"Sir, yes sir!" I reply.
"Well stand on one foot and let's see,"
I raise my bad foot and ankle off the ground and stand on my healthy right foot. The drill instructor has a near stroke.
"Not your good foot! Your other foot, brainstorm!" He roars, his face red with fury, his contempt for my ankle weakness unrestrained.
I do as instructed, switch feet, and promptly fall to the deck, all the while still at attention. He screams at the top of his lungs. "GO SEE THE CORPSMAN!"

Naturally, I did as told. The next day I set out with a crew of sickly recruits to the Navy medical clinic. Some of my company for the short march that day were a bed-wetter, an asthmatic, a home-sick boy bent on getting discharged and busy faking heat stroke (it was November), a kid with a neck abscess the size of a golf ball, and a few more fakers.

"Well, that's a dozie!" The Navy podiatrist said as he looked at my ankle and x-ray. Strangely, he did not swear, insult me or my pathetic ankle, and had a calm demeanor as compared to my four drill instructors, all seemingly hopped up on lethal doses of caffeine and contempt. An ace wrap, some crutches, some ibuprofen, and a note saying that I could not march or run for a few days (light-duty) was the treatment plan. Back at the squad bay, the drill instructors swore to get even with me and my limp ankle upon my being removed from light-duty.
"You think your ankle is sore now, boy? Wait 'till you're off light duty," one drill instructor promised. Another drill instructor made down a count-down calendar so they could build up the drama for my imminent release from light duty. Luckily for me, by the time I was off light duty, the bed -wetter, the heat stroke-faker (who decided to drop the heat stroke theme and tried to kill himself by drinking the platoon's supply of Listerine and got drunk and vomited profusely instead), and the usual myriad of sick perpetual screw-ups had so distracted the drill instructors that they forgot to specifically target my weak left ankle. I managed to graduate boot camp without becoming a cripple.

Years later, in 1993, while in college and doing the pre-med program, a podiatry school recruiter came for a seminar. I remembered for the first time in years the Navy podiatrist who fixed up my ankle and did not swear at me while doing so.

"Maybe I'll go check out this podiatry thing," I told my friend.
"Could be worse things in the world, I suppose." he said.

Happy Marine Corps birthday!!!

Monday, November 9, 2015

The curious mystery of the black and blue toenail...Zimmermann Podiatry

"My toenail is black and blue but I don't remember bumping it!"

As a podiatrist, the curious mystery of the black and blue toenail is in nearly daily mystery to solve. Surprisingly, most black and blue toenails do not show up with an obvious history of trauma such as dropping a bowling ball on or smashing them into the bedpost. Usually a black and blue toenail appears suddenly and is not painful and anyway. Primarily the big toe is affected, for just as Seinfeld declared, the big toe is the king of the toes- and therefore gets all of the adulation and abuse.

If you or someone you know may be suffering from a curiously black and blue toenail with no known history of trauma, the first thing to look for is the size and fitting of your shoes. Over 90% of the time shoes that are too small for the culprit for causing the black and blue toenail, which is nothing more than a bruise underneath the toenail. Runners and athletes frequently get black and blue toenails even though their shoes may fit properly because of the repetitive abuse that their toes get from running or sporting activities.

Sometimes a black and blue toenail is not a simple bruise or an unsightly fungal infection of the toenail, instead he can be a dangerous skin lesion such as malignant melanoma. For suspicious skin lesions like this a biopsy must be taken.

So, if you have a black and blue toenail, don't feel blue- go see a podiatrist!

Zimmermann Podiatry
Erik Zimmermann, DPM
923 West Dixie Ave., Suite B
Leesburg, Florida 34748

Thursday, November 5, 2015

Diabetes? Don't wait to see the podiatrist!

If you have diabetes, you have the unfortunate diagnosis that goes against the old saying: Patience Is A Virtue.

When you have diabetes, waiting around and saying "Let me see how this sore on my foot looks in a few days-" can mean the difference between having a foot in a few days, or being an amputee for the rest of your life. In some instances, diabetics get infections so bad that they die. Diabetes damages every part of your body and impairs both healing and immune response. A simple sore on the foot for a non-diabetic is never the same simple sore on the foot of a diabetic.

Patience may be a virtue, but extreme diligence is a better virtue when it comes to foot care for patients with diabetes.

Zimmermann Podiatry
Erik Zimmermann, DPM
923 W. Dixie Ave. Suite B
Leesburg, FL 34748

Tuesday, September 8, 2015

Why is my toenail so funky looking, and what can I do about it!?!

So, your toenail doesn't look like it did when you were seventeen.

To be honest, your face probably doesn't look the same either, but this is a podiatry blog, not a plastic surgery one, so I will get back to the subject at hand: your toenails!

Maybe your toenail is yellowing, thickening, white and flaky, or maybe crumbling like a poorly built starter home. Either way, there are reasons why your toenail has decided to become a rather unsightly part of your skin, and there are things you can do about it. The most likely culprit is: toenail fungus (onychomycosis). That being said, it is a good bet that if you have toenail fungus, that you also have a fungal infection of the skin of your feet as well. Some studies say it is a 100% probability. Most podiatrists or dermatologists can give you a pretty definite "yes" or "no" just by simply looking at your toenails as to whether you do indeed have the honor of having a toenail infected with fungus. Sometimes a small sample of your nail will need to be sent to a lab to get the final and definitive approval of some lab geek that spends his or her day testing toenail parts for the presence or absence of fungus (and you thought your job stunk).

If the lab results come back positive for fungus, you are left with five basic options:

1. Do nothing. There are worse things than having a funky toenail.
2. Use topical antifungals.
3. Use oral antifungals.
4. Use laser therapy.
5. Use a mixture of topical and oral antifungals as well as laser therapy.

Topical antifungals (prescription topicals) are effective in the treatment of toenails fungus, just be prepared for a slow, long slog of daily applications, for up to one year or more. The effective rate is hard to get a good idea of, as so many patients simply give up using topicals after months of treatment without seeing any improvement. Oral antifungals, the historical gold standard of toenail fungus treatment, are usually taken over a three month course, and the treatment also suffers from slow progress, but taking a pill is much easier than bending over to put medicine on your toenails every day for months on end. The negative of the oral medicine, however, is drug interactions, possible liver damage, and weird side effects such as loss of taste and smell! Blood work is recommended prior to starting oral therapy and during the course of medication as well in order to monitor the effect on your body. Laser therapy, the newest from of treatment, has no side effects and shows an effectiveness rate very similar to the oral medication (generally in the 85% range in my experience). If you have neuropathy or nerve loss sensation you should probably not get laser therapy as you might suffer a burn from the laser. There are usually three to four treatments and they are usually spaced out over a few weeks. Unfortunately, laser therapy is not covered by insurance, and can be expensive.

No matter which form of treatment you choose upon, treatment of your skin is imperative as well, with topical antifungals and anti-fungal foot powder as well. Throw away any disgusting yard shoes or house slippers that you got back in college. They are nothing more than reservoirs of foot disease and should bring shame upon your otherwise good family name. Bleach your bath tub and bath mats and go on a cleaning binge.

It is best to see a podiatrist to check out your toenail problems not only so you can get the right treatment for your toenails, but also to give you a definitive diagnosis that you in fact do have toenail fungus. Eczema, psoriasis, and allergies to dye in your shoes among other things can cause your toenails to get funky. No point in spending your precious time and money treating a non-existent toenail fungus!

Got a funky foot or toenail?

Come see Dr. Z!

Zimmermann Podiatry
Erik Zimmermann, DPM
923 W. Dixie Ave. Suite B
Leesburg, FL 34748

Thursday, September 3, 2015

Quick shoe review: Saucony Redeemer running shoe

For the first time in about 10 years I am wearing a pair of shoes that is not a set of ASICS Gel-Kayanos. Yesterday I put on a pair of Saucony Redeemer running shoes. Kimberly fro Gear For Multi-Sport (clermonttristore.com) in Clermont, FL recommended the Saucony Redeemer shoes due to her knowledge of foot types and biomechanics. She thought that the Saucony Redeemer could give me more motion control than the ASICS Gel-Kayano and that they would not be as stiff as the Brooks Beast (the most rigid of anti-pronation shoes).

After 24 hours I can say that I really enjoy the feel of my new shoes. They offer great arch support but also offer a little more cushion than the ASICS Gel-Kayano and are very comfortable. Beating the Gel-Kayano is quiet an achievement, as the Gel-Kayano is one of the greatest all around shoes there is, especially for one that offers some motion control.

I think that the Saucony Redeemer will be a great fit for most average to above-average pronators, and for those that find the rigidity and the weight of the Brooks Beast to be a little too much. If you have foot pain, go check out Zimmermann Podiatry or a place that has experts on staff and a great selection of spectacular shoes, and you should be back to your old self in no time.

Keep on walking!

Zimmermann Podiatry
Erik Zimmermann, DPM

923 W. Dixie Ave. Suite B
Leesburg, FL 34748

Wednesday, September 2, 2015

Get your feet right with podiatry and the right shoes!

In the office we see many patients with complaints of severe foot pain, sometimes for years. Many of these patients are at their wits ends and ready to have surgery in order to get back on their feet again. I am no longer surprised to see these patients, almost all of whom are wearing either inexpensive shoes or flip-flops or shoes that are made for a different foot type. Usually I can refer them to a place like Gear for Multi Sport, in Clermont, and the patients get professionally fitted for the right shoes, and voila!!! They are back on their feet again, pain free! So if your feet hurt, go see a podiatrist. You may not need surgery, you might just need professional advice as to what shoes or inserts you might need.

Come in to see Zimmermann Podiatry for all of your foot problems.

Erik Zimmermann, DPM

Tuesday, September 1, 2015

Don’t let foot or heel pain, foot problems such as unsightly toenail fungus, skin problems, or diabetic foot care issues keep you down. Dr. Zimmermann has over 15 years experience in keeping patients on their feet and getting them back to their old selves in no time! The office of Zimmermann Podiatry is staffed with the nicest front desk staff you will find, and the office is a one-stop shop for all of your foot care needs. X-rays, diagnostic ultrasound, blood flow testing, and laser treatment for fungal toenails are available in the office, a virtual one-stop shop!
Conservative treatment of painful, thick, fungus toenails as well as calluses are treated professionally and provide great relief from these chronic, unsightly, and painful conditions. For those that wish to kill the fungus in their toenails, Laser therapy is FDA approved for the treatment and cure of just this problem! Common problems such as heel pain, sprains, strains, and other foot pains are all treated after a thorough diagnosis, using the most up to date technology available, including custom orthotics. Numbness and neuropathy issues, commonly seen in diabetics, have recently had a breakthrough in treatments with new topical compounds that have shown a great reduction or cure of these painful symptoms in many patients.
All diabetics need to be aware of the very serious problems that can occur to their feet, and all should visit a podiatrist regularly for diabetic foot care. Simple toenail and callus care of a diabetic patient, done by a skilled podiatrist, has proven to be one of the most beneficial things a diabetic can do in order to ensure their overall health as well as the health of their feet.
So come on down to see Dr. Zimmermann and his staff! Our office is located at 923 W. Dixie Avenue, Suite B, Leesburg. Call 352.435.7849 or visit the website: www.drzpodiatry.com