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December 21, 2018
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What are Corns and Calluses?

Corns and calluses are your body's response to friction or pressure against the skin. If your foot rubs inside your shoe, the affected area of skin thickens. Or if a bone is not in the normal position, skin caught between bone and shoe or bone and ground builds up. In either case, the outer layer of skin thickens to protect the foot from unusual pressure. In many cases, corns and calluses look bad but are not harmful. However, more severe corns and calluses may become infected, destroy healthy tissue, or affect foot movement. But with your doctor's help, corns and calluses can be controlled.

Where do Corns and Calluses form?

A corn or callus is a thickening of the outer layer of skin on your foot. Corns usually grow on top of the foot, often at a toe joint. Calluses spread on the bottom of the foot or on the outer edge of a toe or the heel.

Corns can range from a slight thickening of skin to a painful, hard bump. They often form on top of buckled to joints (hammer toes). If your toes curl under, corns may grow on the tips of the toes. You may also get a corn on the end of a toe if it rubs against your shoe. Corns can also grow between toes, often between the first and second toes.

Calluses may spread across the ball of your foot. This type of callus is usually due to a problem with a metatarsal ( the long bone at the base of a toe, near the ball of the foot). A pinch callus may grow along the outer edge of the heel or the big toe. Some calluses press up into the foot instead of spreading on the outside. A callus may form a central core or plug of tissue where pressure is greatest.

Treating Corns and Calluses

If your corns or calluses are mild, reducing friction may help. Different shoes, moleskin patches, or soft pads may be all the treatment you need. In more severe cases, treating tissue buildup may require your doctor's care. Sometimes orthoses (custom made shoes inserts) are prescribed t reduce friction and pressure.


July 25, 2018
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Although they may develop on the fifth little toe, bunions usually occur at the base of the big toe. Bunions are often caused by incorrect foot mechanics. The foot may flatten too much, forcing the toe joint to move beyond normal range. In some cases, joint damage caused by arthritis or an injury produces a bunion. And some people are born with the tendency to develop bunions. If you're at risk of developing a bunion, wearing high-heeled or poorly fitting shoes makes the problem worse.



Positional Bunions

      As the new bone grows, the joint enlarges. This stretches the joint's outer covering. Force created by the stretching pushes the big tow toward the smaller ones. Eventually, the inside tendons tighten, pulling the big toe farther out of alignment.


Structural Bunions

     When the angle between the bones of the first and second toes is greater than normal, the big toe slants toward the smaller ones. In severe cases, this may also cause the second and third toes to buckle.



If a bunion is not painful or severe, your doctor may recommend that you wear a different style of shoes. Or you may be prescribed custom made shoe inserts (orthoses) to control incorrect foot mechanics. For painful or sever bunions, outpatient surgery may be recommended. After surgery you'll soon be on your way home and ready for recovery.

July 11, 2018
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What is Gout?

Gout is a disease that affects the joints. Left untreated, it can lead to painful foot deformity and even kidney problems. The good news is that by treating gout early, you can relieve pain and help prevent future problems. Gout can usually be treated with medication and proper diet. In severe cases, surgery may be needed.

What causes Gout?

Gout is caused by an excess of uric acid (a waste product  made by the body). The uric acid forms crystals that collect in the joints, bringing on a gout attack. If you have many gout attacks, crystals may form large deposits called tophi. Tophi can damage joints and cause deformity.

Treating Gout Attacks

Gout attacks are painful and often happen more than once. Taking medications may reduce pain and prevent attacks in the future. There are also some things you can do at home to relieve symptoms.

- Rest the painful joint as much as you can.

-Raise the painful joint so it is at a level higher than your heart.

Preventing Gout

With a little effort, you may be able to prevent gout attacks in the future. Here are some things you can do:

-Avoid alcohol and foods that trigger gout.

-Take any long-term control medications prescribed by your doctor.

-Lose weight if you need to.

- Control blood pressure and cholesterol.

-Drink plenty of water to help flush uric acid from your body.

During a Gout Flare Up, Avoid All...

Artificial sweeteners, carbonated or fizzy drinks, cigarettes, flour (white & wheat), goat, lamb, pastries, pork, sugar, beer, brown sugar, deer, chocolate, coffee, custard with white sugar, jams, jellies, liquor, pasta, rabbit, semolina, table salt ( refines & iodized), black tea, turkey, breads (white & wheat), white rice, and vinegar.

Food to Eat more of to Help Lower Uric Acid Related to Gout

-Food high in complex carbohydrates such as whole grains, fruits and vegetables

-Foods low in protein such as tofu, lean meats and poultry

-Dark berries and especially cherries may lower uric acid and reduce inflammation

-Oils found in Salmon, flax or olive oil, or nuts may reduce inflammation


Nutrition and Supplements

-Eliminate potential food allergens, including dairy, wheat (gluten), corn preservatives, and food additives. Your health care provider may test for food sensitivities.

-Eat antioxidant foods, including fruits ( such as blueberries, cherries and tomatoes), and vegetables (such as squash and bell peppers). Some nutrition minded doctors promote a low fructose diet to treat gout. Another theory sates that one half  pound of cherries per day ( fresh or frozen)for 2 weeks lowers uric acid and prevents attacks. Cherry juice (8 to 16 oz per day) is also helpful.

-Eat more high fiber foods, including oats, root vegetables ( such as potatoes and yams), and psyllium seed.

-Avoid refined foods, such as white bread, pastas, and sugar.

-Eat fewer red meats and more lean meats, cold water fish, tofu or beans for protein.

-Cut down on foods containing oxalate, such as spinach, rhubarb, beets, nuts, chocolate, black tea, wheat bran, strawberries, and beans.

-Include foods rich in magnesium and low in calcium, such as barley, bran, corn, rye, oats, soy, brown rice, avocado, banana, and potato.

-Restrict purines in your diet. Foods with a high purine content include beef, goose, organ meats, sweetbreads, mussels, anchovies, herring, mackerel, and yeast. Foods with a moderate amount of purines include meats, poultry, fish and shellfish not listed above. Spinach, asparagus, beans, lentils,  mushrooms, and dried peas also contain moderate amounts of purines.

-Use healthy cooking oils, such as olive oil or coconut oil.

-Reduce or eliminate trans fatty acids, found in commercially baked goods, such as cookies, crackers, cakes, french fries, onion rings, donuts, processed foods, and margarine.

-Avoid alcohol and tobacco.

- Drink 6 to 8 glasses of filtered water daily to help flush uric acid from the body. Dehydration often triggers a gout attack.

-Exercise at least 30 minutes daily, 5 days a week.

-Avoid sugar sweetened soft drinks. Diet soft drinks have not been associated with the risk of gout.

July 11, 2018
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Ingrown Toe Nails

An Ingrown Toe nail is a very common painful condition in which the nail grows so that it cuts into one or both sides of the paronychium or nail bed.


Symptoms of an ingrown nail include pain along the margins of the nail, worsening of pain when wearing tight footwear, and sensitivity to pressure of any kind, even the weight of bed sheets. Bumping of an affected toe can produce sharp, even excruciating, pain as the tissue is punctured further by the nail.  By the very nature of the condition, ingrown nails become easily infected unless special care is taken. Signs of infection include redness and swelling of the area around the nail, drainage of pus, and watery discharge tinged with blood.


Permanent correction of ingrown nails is a very commonly performed procedure here in our office. It offers permanent relief of a very painful problem. This procedure involves a local anesthetic  (numbing the toe) so that no pain and discomfort occurs during the procedure itself. The procedure involves the removal of the small section of the nail which is ingrowing, then the nail root is killed with a chemical. This causes very little post-procedure discomfort, however pain medicines are given should discomfort arise. Following this surgery, specific soaking instructions are given as the risk of infection is always a possibility. You will also be given oral antibiotics to prevent infection.  The skin on the sides of the nail will eventually meet the remaining portion of the nail and the nail will usually have a fine cosmetic result.

January 19, 2016
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Nail problems


The nails protect the nerve rich fingertips and tips of the toes from injury. Nails are a substance of the epidermis (the outer layer of the skin) and are composed mainly of Keratin, a type of protein. The nail bed is the skin on top of which the nails grow. Nails grow from 0.05 to 1.2 mm a week. If a nail is lost, it takes about seven months to grow out fully.

            Healthy nail beds are pink, indicating a rich blood supply. Changes or abnormalities in the nails are often the result of nutritional deficiencies or other underlying conditions. The nails can reveal a great deal about the body's internal health.


            The following are some of the changes that nutritional deficiencies can produce in the nails:


  • A lack of protein, folic acid, and vitamin C causes hangnails. White bands across the nails are also an indication of protein deficiency.

  • A lack of vitamin A and calcium causes dryness and brittleness.

  • A deficiency of B vitamins causes fragility, with horizontal and vertical ridges.

  • Insufficient intake of vitamin B 12 can lead to excessive dryness, very rounded and curved nail ends, and darkened nails.

  • Iron deficiency may result in "spoon" nails (nails that develop a concave shape) and or vertical ridges.

  • Zinc deficiency may cause the development of white spots on the nails.

  • A lack of sufficient "friendly" bacteria (lactobacilli) in the body can result in the growth of fungus under and around nails.

  • A lack of sufficient hydrochloric acid (HCI) contributes to splitting nails.


    The following lists recommendations to promote healthy nail growth:



  • For healthy nails, be sure to get plenty of quality protein, and take a protein supplement. Eat grains, legumes, oatmeal, nuts, and seeds. Eggs are also good source of protein, as long as your blood cholesterol levels are not too high.

  • Eat a diet composed of 50% fresh fruits and raw vegetables to supply necessary vitamins, minerals, and enzymes. Eat foods that are rich in sulfur and silicon, such as broccoli, fish, onions, and sea vegetables. Also include in the diet plenty of foods that are high in biotin, such as Brewer's yeast, soy flour, and whole grains.

  • Drink plenty of quality water and other fluids. Cuts and cracks in the nails may indicate a need for more liquids.

  • Drink fresh carrot juice daily, this is high in calcium and phosphorus and is also very good for strengthening for nails.

  • Consume citrus fruits, salt, and vinegar in moderation, if it all. Excessive intake of these foods can result in a protein/calcium imbalance that may adversely affect the health of nails.

  • Supplement your diet with Royal jelly, a good source of essential fatty acids, and spirulina or kelp, which are rich in silica, zinc, and B vitamins, and help to strengthen nails.

  • To restore color and texture to brittle yellowed nails, make a mixture of equal parts of honey, avocado oil, and egg yolk, and add a pinch of salt. Rub the mixture into your nails and cuticles. Leave it on for half an hour, then rinse it off. Repeat this treatment daily. You should begin to see results after about two weeks.

  • To strengthen the nails, try soaking them in warm olive oil or cider vinegar for 10 to 20 minutes daily.

  • Treat your nails gently. Usingthem to pry, pick, scrape, or perform tasks such as removing staples can damage them.

  • Keep your nails relatively short. Nails longer than 1/4 inch beyond the fingertip break and bend easily.

  • Do not cut the cuticles. Uncovering the nails this way is harsh and irritating, and may cause infection use baby oil or cream and gently push the cuticles back.

  • Soak your nails before trimming them. Nails are most likely to split and peel when they are dry. Apply hand cream each morning and evening to prevent nails from drying out.

  • Do not repeatedly immersed your hands in water that contains detergents or chemicals such as bleach or dish soap; this results in split nails. Wear cotton-lined gloves when doing housework such as dishes and laundry or when using furniture polish. This protects your hands and nails against harsh chemicals. Wearing gloves is especially important for people who work in jobs where their hands are exposed to chemicals. Not only does this damage the nails but it causes the skin surrounding the nail bed to dry out and crack. This can lead to bleeding and can be quite painful.

  • Do not pull at hangnails. Cut them with sharp clippers or scissors. Keep your hands moisturized to help prevent hangnails.

  • If you are diabetic, see your healthcare provider if your cuticles become inflamed, because the infection can spread.

  • If you wear nail polish, use a base coat underneath it to prevent yellowing.

  • Use nail polish removers as little as possible. They contain solvents that leach lipids from the nails and make them brittle. These solvents are also potentially highly toxic, and can be absorbed through the skin.

  • Never apply artificial nails over your own. They may look nice for a while, but they destroy the underlying nail. The chemicals and glue used are dangerous to the body, and are readily absorbed through the damaged nail and nail bed. The use of artificial nails has been known to contribute to the development of fungal infections of the fingernails.




    -If you expose your hands to too much water and soap, the nail maybe come loose from the nail bed. Water causes the nails to swell. They then shrink as they dry, resulting in loose and brittle nails.

    -Discolored nails can be caused by prolonged illness, stress, nicotine, allergies, or diabetes. If your nails are green, you may have a bacterial infection or fungal infection between the nail and nail bed.

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