Archive for February, 2010
Regents Academy – The Big Serve – Nacogdoches Texas school
Posted by: | CommentsI attended a special event at Regents Academy in Nacogdoches Texas on Tuesday night. “The Big Serve” is a fundraising event for the school where the students go out into our community and serve others. Even though there was snow on the ground, there was a huge crowd, great food and I think everyone had a great time! The students will be visiting nursing homes, cleaning up city parks and doing construction projects for the needy in our community. Friends and family will be supporting their efforts through donations. Regents Academy is a private Christian school that teaches using a classical approach to education. Our family loves it and we are very involved in helping it succeed with the Lord’s blessing. I feel service is a great lesson to teach children and I applaud Regents for doing it. Go Eagles!
Athlete's Foot
Posted by: | CommentsProbably one of the most missed diagnosis of the foot I see is Chronic Dermatophytosis, aka Athlete’s Foot. We all seem to recognize the acute form many get in high school where the feet itch excessively and the skin between the toes is wet and has turned white, aka maceration but we often mistake the chronic type of dermatophytosis as dry skin. Patient say, “Doc I keep putting moisturizing cream on my skin but they still look dry”. Well that’s because their problem is a fungus, not dry skin.
You do not have to be a member of a sports team to get athlete’s foot. In fact, believe it or not, you don’t even have to play a sport. The condition itself usually results from an overgrowth of a particular fungus organism. In most cases, the areas between the toes and the arch of the foot are most often involved. Athlete’s foot may appear in different stages, each with its own presentation. For instance, the acute stage may have blisters or have intense itching. In addition, there may be maceration between the toes and occasional drainage. The chronic condition is characterized more by a dry and scaly appearance and rarely itches. My favorite description of chronic dermatophytosis (yes I have a favorite!) is “a moccasin distribution of dry ruptured vesicles”. There is some confusion as to how this skin condition can be transmitted but at the present time, the consensus of opinion is that there is a contagious capacity. In short, you might be able to catch it from the next guy or gal, so watch your barefoot walking! Also, it can come from fungal toenails if you have those.
Occasionally, an athlete’s foot condition will become infected and require more extensive therapy. In actuality, the threat of subsequent infection is probably a prime reason for treating more aggressively the earlier stage of the condition. After all, one might ask, what is really so bad about a little itching between the toes. Well, by itself, probably not a whole lot. But in those cases where that little itching develops into a more involved complication, then we might be facing a more serious problem.
At the first sign of an athlete’s foot condition, I would recommend a short trial period of a medicinal preparation available at the pharmacy in spray or cream varieties. Following several days use, if the condition persists, I would recommend a visit to the foot specialist. One thing is for sure, do not give up your athletic status in the hopes of relinquishing your athlete’s foot!
Achilles Tendonitis – Foot Pain in Nacogdoches
Posted by: | CommentsThe Achilles tendon is the thickened cord or fibrous band that runs down the back of one’s leg and attaches to the heel bone. A prime function of this muscle or tendinous structure is to assist in moving the foot up and down. Athletes at all competitive levels, frequently encounter problems with this tendon. It is subject to injury from a direct impact, can suffer from over use or excessive training, or can just start hurting as a result of shoe pressure. The patient with an Achilles tendonitis will most often have pain and swelling in the lower portion of the tendon just above the heel, will have discomfort when moving the foot upwards thus stretching the tendon, and will probably note that the condition has worsened over time. These patients can have significant discomfort and will frequently take themselves out of physical activities prior to visiting the physician.
Although we are unsure why certain individuals are more prone to develop this problem than others, there are certain factors, which seem to appear in the “cause” column. Trauma or injury to the Achilles tendon itself is an obvious cause of subsequent tendonitis. An abnormality in the way that one walks or what the medical authorities refer to as improper biomechanics can also create excessive strain upon the Achilles tendon resulting in localized swelling and pain. Over use, excessive training and improper stretching can also result in Achilles tendon injuries. The bottom line though, in most cases of Achilles tendonitis, is the same…pain, reduced range of motion, localized swelling, and a potential long-term problem that is usually slowly responsive to therapy.
In discussing the treatment approaches to an Achilles tendonitis, we must first mention the necessity of a thorough examination by a specialist. Fractures of the heel bone, partial ruptures of the tendon itself, and localized soft tissue problems must all be carefully considered and ruled out. The specific treatment of an Achilles tendonitis might include physical therapy, shoe padding (lifts to raise the heel), possible orthotics, oral anti-inflammatory medication, some form of immobilization, and reduced physical activity until the condition improves. Surgery, although mentioned for completeness is rarely used. It should be mentioned that this painful and often disabling condition, while frequently slow to respond, will usually improve and resolve with therapy over time.
My Favorite Patient Story
Posted by: | CommentsWhen I was a new podiatrist in East Texas it was not uncommon to have a patient sit in my chair and compare me to their last podiatrist. For a new doctor you can imagine this was a bit unsettling because one is never sure how he measures up to the “competition”. Anyway, I’ll never forget my 85 year old patient who had decided to try out the “new guy” after years of driving to Shreveport to see her regular podiatrist. Curious about the podiatrist in Shreveport, I asked what he was like:
“Well”, she said, “He is very good. He is very gentle and very nice to talk to. He seems to be very knowledgeable and knows exactly what to say and when to say it. Oh, and he has wonderful hands. You can barely tell when he is working on you.” She continued’ “ His hands are incredibly soft and his fingers were long and tapered just so.” “I told him once that his hands were so nice they belonged on a woman” she exclaimed.
I asked her what his response was.
She said his reply was, “Sometimes they are!”
Lol, that is one of my favorite patient stories and is as true as I can remember it. I’ll bet he was a good podiatrist with a sense of humor like that.
Why did I choose Podiatry?
Posted by: | CommentsI’m often asked why I became a podiatrist. Well one of the best things about being a podiatrist (other than the glamor of it all) is that I get to provide a very diverse set of services to a very diverse group of patients in very diverse medical settings. My care can range from basic foot care to complicated surgical repairs on patients ranging from newborns to over one hundred years of age. I work in nursing homes, two private offices and multiple hospitals and surgery centers. As you can see, one of the great things about podiatry is that it is unlikely to get boring. To top it all off, almost all my patients have less pain when they leave than when they arrive so, usually, they are very happy to see me! Did you know that about 5 percent of the US population sees a podiatric physician each year and there were more than 55 million patient visits in 1995 and there are about 10,735 active podiatric physicians in the United States today? There is an average of one podiatric physician for every 24,624 people.
Podiatry has proven to be a very satisfying choice for me. It keeps me busy and allows me to help relieve the pain of many of my patients.
Nacogdoches Podiatrist Starts a Blog
Posted by: | CommentsMy name is Dr. Mark E. Sowell, DPM and I have been practicing podiatry in my hometown of Nacogdoches Texas for over ten years. I have started this blog to discuss common foot ailments, answer questions about the foot and to generally rant about whatever amuses me at the time. Feel free to comment and hopefully I’ll get better as time goes on. My professional areas of interest are diabetic footcare, sports medicine, woundcare and foot surgery. So if it has to do with the foot it is very likely I will be discussing it here. Also, I’m sure I’ll be discussing areas of personal interest as well. Who knows! Let me know what you think. Bye for now.
