Foot, Ankle & Lower Leg Center: June 2011

Friday, June 24, 2011

Diabetes and Feet: Why A Podiatrist Is A Vital Part Of A Diabetic's Care

Diabetes and Feet: Why A Podiatrist Is A Vital Part Of A Diabetic’s Care

Posted on: Zimbio

Diabetes is a serious disease that affects millions of Americans, and that number is going to astronomically grow as the baby boomer generation ages further. Complications associated with diabetes can be devastating, and can lead to organ failure and even death. Foot-related complications in particular are very common in diabetes, and unfortunately cause the majority of leg amputations performed by surgeons. Comprehensive care by a podiatrist can identify foot problems early before they lead to leg loss, and in many cases can prevent those problems in the first place. This article will discuss the ways a podiatrist can protect diabetic feet, and ultimately save a diabetic’s limb and life.

Diabetes is a disease in which glucose, the body’s main source of ‘fuel’, is not properly absorbed into the body’s tissues and remains stuck in the bloodstream. Glucose is a type of ‘sugar’ derived from the body’s digestion of carbohydrates (grains, breads, pastas, sugary food, fruits, starches, and dairy) The body needs a hormone called insulin, which is produced in the pancreas, to coax the glucose into body tissue to fuel it. Some diabetics are born with or develop at a young age an inability to produce insulin, resulting in type 1 diabetes. The majority of diabetics develop their disease as they become much older, and the ability of insulin to coax glucose into tissue wanes due to a sort of resistance to or an ineffectiveness of the action of insulin. This is called type 2 diabetes. Diabetes can also develop from high dose steroid use, during pregnancy (where it is temporary), or after pancreas disease or certain infections. The high concentration of glucose in the blood that remains out of the body tissue in diabetes can cause damage to parts all over the body. Organs and tissue that slowly are damaged by high concentrations of glucose stuck in the blood include the heart, the kidneys, blood vessels, the brain, the nerve tissue, skin, and the immune and injury repair cells. The higher the concentration of glucose in the blood, and the longer this glucose is present in the blood in an elevated state, the more damage will occur. Death can occur with severe levels of glucose in the blood stream, although this is not the case in most diabetics. Most diabetics who do not control their blood glucose well develop tissue damage over a long period of time, and serious disease, organ failure, and the potential for leg loss does eventually arrive, although not right away.

Foot disease in diabetes is common, and one of the more devastating and taxing complications associated directly and indirectly with high blood sugar. Foot disease takes the form of decreased sensation, poor circulation, a higher likelihood of developing skin wounds and infections, and a decreased ability to heal those skin wounds and infections. Key to this entire spectrum of foot complications is the presence of poor sensation. Most diabetics have less feeling in their feet than non-diabetics, due to the indirect action increased glucose has on nerve tissue. This decreased sensation can be a significant numbness, or it can be a mere subtle numbness that makes sharp objects seem smooth, or erases the irritation of a tight shoe. Advanced cases can actually have phantom pains of burning or tingling in addition to the numbness. With decreased sensation comes a much greater risk for skin wounds, mostly due to the inability to feel pain from thick calluses, sharp objects on the ground, and poorly fitting shoes. When a wound has formed as a result of skin dying under the strain of a thick corn or callus, from a needle or splinter driven into the foot, or from a tight shoe rubbing a friction burn on the skin, the diabetic foot has great difficulty starting and completing the healing process. Untreated skin wounds will break down further, and the wound can extend to deeper tissue, including muscle and bone. Bacteria will enter the body through these wounds, and can potentially cause an infection that can spread beyond the foot itself. A diabetic’s body has a particularly difficult time defending itself from bacteria due to the way high glucose affects the very cells that eat bacteria, and diabetics tend to get infected by multiple species of bacteria as well. Combine all this with decreased circulation (and therefore decreased distribution of nutrients and chemicals to preserve foot tissue and help it thrive), and one has all the components in place for a potential amputation. Amputations are performed when bacteria spreads along the body and threatens death, when wounds and foot tissue will not heal as a result of gangrene from advancing tissue death and infection, and when poor circulation will not allow the tissue to thrive ever again. The statistics following a leg amputation are grim: about half of diabetics who undergo one amputation will require an amputation of the other foot or leg, and about that same number in five years will be dead from the heart strain endured when one’s body has to expend energy to use a prosthetic limb.

A podiatrist can ensure that all the above complications are significantly limited, and in some cases prevented all together. Podiatrists are physicians who specialize solely in the care of foot and ankle disease, through medicine and surgery. The attend a four year podiatric medical school following college, and enter into a two or three year of hospital-based residency program after that to hone their advanced reconstructive surgical skills, and to study advanced medical. Podiatrists are generally considered the experts on all things involving the foot and ankle, and their unique understanding amongst other medical specialties of how the foot functions in relationship to the leg and ground (biomechanics) allows them to target therapy towards controlling or changing that function in addition to treating tissue disease. A great majority of the problems that lead to diabetic amputations start off as problems related to the structure of the foot and how it relates to the ground and to the shoe worn above. Controlling or repairing these structural problems will often result in prevention of wounds, which in turn will prevent infection, gangrene, and amputation.

To start with, a podiatrist will provide a diabetic patient with a complete foot exam that takes into account circulation, sensation, bone deformities, and skin issues, and pressures generated by walking and standing. From this initial assessment, a protection and treatment course can be created specific to the individual needs of the diabetic for maintenance, protection, and active treatment of problems that do develop. Commonly performed maintenance services include regular examinations several times a year to identify developing problems, care of toe nails to prevent a diabetic with poor sensation from accidentally cutting themselves when attempting to trim their nails, regular thinning of calluses to prevent wounds from developing, and repetitive education on diabetic foot problems to ensure proper habits are followed. Preventative services include using special deep shoes with protective inserts in diabetics at-risk for developing wounds from regular shoes, assessment of potential circulation problems with prompt referral to vascular specialists if needed, and possible surgery to reduce the potential of wounds to develop over areas of bony prominences. Active treatment of foot problems performed by a podiatrist involves the care and healing of wounds, the treatment of diabetic infections, and surgery to address serious foot injury, deep infections, gangrene, and other urgent problems. Because of a podiatrist’s unique understanding of the way the foot structure affects disease and injury, all treatment will be centered around the principles of how the foot realistically functions in conjunction with the leg and the ground. This becomes invaluable in the struggle to prevent diabetic wounds and infections, while allowing one to remain mobile and active at the same time.

The essential goal of a podiatrist in caring for a diabetic patient is to prevent wounds, infections, and the amputations that result. This philosophy is called limb salvage, and it is accomplished through the above listed methods. Because of the severity of foot disease as a complication of diabetes, a podiatrist is an integral part of a diabetic’s care, and sometimes can even be the physician that diagnoses diabetes in the first place if foot disease appears as an early symptom of undiagnosed diabetes. For these reasons, all diabetics should be assessed by a podiatrist for potential problems, and those at-risk for foot wounds and infections should have regular foot examinations and preventative treatment. As a final note, online resources by podiatrists discussing diabetic foot issues abound, including a regular blog by this author (thediabeticfoot.blogspot.com). While these resources do not replace a diabetic foot exam, they do help educate diabetics on how best to care for their feet, and what to do if problems develop. This can lead to better knowledge and understanding of foot issues when diabetics begin to see a podiatrist regularly, and can help prevent early foot complications from developing.

Please call the Foot, Ankle & Lower Leg Center office anytime @702-878-2455 between Monday – Friday and we would be happy to set up an appointment for you. Please visit our website @ www.FallCenter.com or www.walkwithdiabetes.com. The Foot, Ankle & Lower Leg Center has Diagnostic imaging: Digital X-Rays, Ultrasound or Advanced Imaging will be used to aid in the diagnosis.

Dr. Anthony Ricciardi at the Foot, Ankle & Lower Leg Center has completed training in endoscopic/minimally invasive surgery for chronic heel pain and nerve pain, foot and ankle joint replacement for restoring pain free motion, arthroscopic surgery, bunion surgery, fracture repair, flat foot correction, external fixation for complex deformities and extensive experience in peripheral nerve surgery including diabetic peripheral neuropathy and reconstructive surgery of previously failed foot surgical procedures. In addition to his surgical training Dr. Ricciardi focuses on sports medicine of the foot and ankle through regenerative techniques using the patient’s own blood/platelets for healing chronic foot and ankle problems (pain) as a result of repetitive sport injuries. This cutting edge technology enables patients to continue training with little or no down time. Dr. Ricciardi continues to be active in teaching and training other podiatric surgeons on innovative surgical techniques in foot surgery. Dr. Ricciardi is Board Certified by the American Board of Podiatric Surgery, a Fellow of the American College of Foot and Ankle Surgeons and Fellow of the Association of Extremity Nerve Surgeons. Dr. Ricciardi’s vision is to bring each patient the most current state of the Art Technology and personalized treatment options to meet their Foot and Ankle needs (from conservative care to surgical options). Dr. Ricciardi believes in quality service and puts his patients first!

Tuesday, June 21, 2011

How to find the right summer shoes for kids

How to find the right summer shoes for kids

Protect your children with the proper footwear for the occasion.

Published by: Dayton Daily News

Summer means new ground for little feet to cover. Whether it’s sand, water, dirt or grass, kids will be busy running, swimming, climbing and jumping.

Improper foot support can lead to aches, pains and sprains.

Shoes to avoid

“As a mom, it’s hard not to buy all of the cute shoes that are out for summer! However, in order to prevent tripping and maintain good contact with the foot bed of the shoe to improve support, it is best to avoid flip-flops,” said Dana Gifford, physical therapist at Dayton Children’s Medical Center and mother of two.

Flip-flops can lead to problems including stubbed toes, blisters, arch and heel pain, tendinitis and sprained ankles.

Dr. Tanya Remer Altmann, pediatrician, author and expert for www.striderite.com, cautions against wearing flip-flops every day.

“Flip-flops do not offer kids enough protection or support for daily wear. They are fine for brief periods of time at the pool or beach.” Altmann said. “I see many children with foot pain after a long summer of walking barefoot or wearing unsupported sandals as well as injured toes and feet from sandals and flip-flops that lack protection.”

Shoes to consider

If parents cannot resist flip-flops, Gifford advises choosing styles with a back strap.

“Sport-style sandals offer more coverage and support than flip-flops and are also a better choice than open-toed sandals for balance and support,” Gifford said.

Crocs can be an option if worn correctly.

“Crocs tend to be worn loose on the foot and therefore offer less support and stability. However, when they fit snug, they do offer good flex of the sole as well as being closed-toe and having a back strap,” Gifford said.

Shoes for toddlers

Gifford advises that toddlers and new walkers, because they have developmentally flat feet, do not need arch support from a shoe, but instead require a shoe that provides a substantial amount of flex to allow their feet to move freely.

“Toddlers benefit from closed-toe shoes that are relatively close-fitting (don’t allow a lot of wiggle room side to side). Open-toed shoes do not provide the amount of stability that a closed-toe shoe does,” Gifford said. “They are learning many new gross motor skills and require good support for all of the challenging new balance activities, as well as learning to walk in the grass, mulch or sand.”

Shoes for older children

School-age kids need more support and cushioning, and flexibility at the ball of the foot from their shoes. Preteens and teenagers’ feet are nearing maturity and for those who play sports will require specific support from their shoes, Gifford said.

Right fit essential

Once you’ve found the right shoe for your child’s need, you need to find the right fit.

Because kids have feet that are slightly different in size, the larger foot should determine the shoe size, Gifford said. She recommends measuring the foot while your child is standing and allowing about a half-inch of growth room at the end of the shoe.

“Your child’s foot should not slip within the shoe when walking, nor should it be pushed against the sides of the shoe,” Gifford said.

Dr. Jacqueline Sutera, spokeswoman for the American Podiatric Medical Association, advises parents to use the store’s measuring stick to obtain the length and width of their child’s foot as a starting point to finding the right fit.

Altmann recommends seeking out an expert for measuring toddlers’ feet.

Matching the right shoe to each summer activity is also important in protecting growing feet.

“I recommend that children wear sneakers during the summer for daily walking, running and jumping. There are many lightweight, breathable and washable options, with proper heel cushioning, mid foot support, flexibility, good traction and rounded edges to decrease stumbles and falls. If you do want a sandal for summer heat and splashing in the water, choose a sneaker type sandal with cutouts and mesh — a much better choice than flat, non-cushioned flip-flops,” Altmann said.

Saturday, June 18, 2011

Do Pretty Toenails Put You at Risk for Infection?

Do Pretty Toenails Put You at Risk for Infection?

Published by: Patch.com

Asking your nail salon the right questions can save you from skin and nail infections.

The sun is out, the air is warm and Minnesotans are baring their toes.

As we head to salons to have our feet and nails buffed and polished, many of us are not aware of questions we should be asking to make sure we don’t end up with yellow toenails or more dangerous skin infections.

Fungal infections of the nails and skin, called dermatomycoses, are more commonly known as “ringworm” infections. They can cause thickening and yellowing of toenails and athletes foot. Other related fungal diseases are body ringworm, jock itch (groin ringworm) and even scalp and beard ringworm.

These fungi don’t cause dangerous diseases in healthy individuals, but are unsightly, itchy and hard to get rid of. You can pick them up at the gym, the pool, or at the nail salon if equipment hasn’t been properly cleaned and sterilized.

Staph infections, caused by the bacteria Staphylococcus aureus, can be much more dangerous—even deadly. Staph bacteria live on people’s skin and can invade your body through a hair follicle or a break in the skin. Some staph bacteria have become resistant to antibiotics, and it can be very difficult to treat the infections they cause.

Fortunately, there are steps you can take to make sure you leave the salon with pretty nails but without a nasty fungal or bacterial infection.

First of all, ask your salon how they sterilize their equipment between customers. Autoclaving is best (high heat plus pressure), but soaking instruments in a germicidal disinfectant for at least 10 minutes between customers is allowed in most states. New files should be used for each client.

Don’t let a nail technician cut your skin with a clipper or blade. Remember, bacteria enter skin through cuts and nicks.

Along the same lines, don’t shave your legs within 24 hours of getting a pedicure. You should also reschedule if you have a cut, crack or open blister on your feet or legs.

Ask how often soaking tubs are cleaned and disinfected. Ideally, salons should put a clean plastic bag over the tub for each customer. Remember, you can bring your own equipment (files, buffers or even tub-liners) for a safer pedicure!

Following a pedicure, watch for new pimples or sores that look like bug bites on your feet or legs, calling your doctor immediately if you see one. Infections are often easy to cure if caught early on, but can be dangerous if left unattended.

Toenails fungus is extremely common and very hard to treat, so it’s best to avoid getting it in the first place by making sure pedicure equipment has been properly sterilized.

Edina’s Spalon Montage uses Opi’s Spa Complete system to make sure their clients aren’t exposed to harmful germs. Pedicure instruments are washed and soaked for a minimum of ten minutes in a hospital grade disinfectant containing the antimicrobial agent Dimethyl Ammonium Chloride. Foot baths are cleaned thoroughly between customers, using the same chemical.

Don’t stay away from pedicures. Show off those pretty toes. Just be sure that your nail salon is doing their best to keep you healthy!

Monday, June 13, 2011

Don't Let Your Feet Ruin Your Day at the Beach

Published by: American College of Foot and Ankle Surgeons

As millions of Americans hit the beach this summer, the American College of Foot and Ankle Surgeons offers these foot safety tips:

Puncture wounds and cuts

Wear shoes to protect your feet from puncture wounds and cuts caused by sea shells, broken glass and other sharp objects. Don’t go in the water if your skin gets cut – bacteria in oceans and lakes can cause infection. A puncture wound should be treated by a foot and ankle surgeon within 24 hours to avoid complications.

Jellyfish stings

Remember that a jellyfish washed up on the beach can still sting if you step on it. If their tentacles stick to the foot or ankle, remove them, but protect your hands from getting stung too. Vinegar, meat tenderizer or baking soda reduce pain and swelling. Most jellyfish stings heal within days, but if they don’t, see a doctor.

Sunburns

Feet get sunburn too. Rare but deadly skin cancers can occur on the foot. Don’t forget to apply sunscreen to the tops and bottoms of your feet.

Burns

Sand, sidewalks and paved surfaces get hot in the summer sun. Wear shoes to protect your soles from getting burned, especially if you have diabetes.

Ankle injuries, arch and heel pain

Walking, jogging and playing sports on soft, uneven surfaces like sand frequently leads to arch pain, heel pain, ankle sprains and other injuries. Athletic shoes provide the heel cushioning and arch support that flip-flops and sandals lack. If injuries occur, use rest, ice, compression and elevation to ease pain and swelling. Any injury that does not resolve within a few days should be examined by a foot and ankle surgeon.

Diabetes risks

People who have diabetes face serious foot safety risks at the beach. The disease causes poor blood circulation and numbness in the feet. A person with diabetes may not feel pain from a cut, puncture wound or burn. Any type of skin break on a diabetic foot has the potential to get infected and ulcerate if it isn’t noticed right away. People with diabetes should always wear shoes to the beach, and remove them regularly to check for foreign objects like sand and shells that can cause sores, ulcers and infections.

Tuesday, June 7, 2011

Ultimate Exercises for Stylish Feet

published by: American Podiatric Medical Association (APMA)

Discover four simple ways to strengthen and stretch your tired toes.

http://www.apma.org/footexercises

Monday, June 6, 2011

Georgia Faces Child Diabetes Epidemic

Posted by: The Financial

The FINANCIAL -- The number of children with diabetes increased by over 14% in the last 10 years according to statistics of the Diabetic Children’s Protection Association of Georgia.

The increase is about 14%, which is twice as much as the rate of diabetes type II. By 2010 the number of diabetic children increased by 30. The Association has recorded 49 cases of diabetes in children during the 5 months of 2011. There are two main types of Diabetes. Type I is an auto-immune disease, known as juvenile-onset diabetes. It can appear very quickly and aggressively. It may lead to coma or loss of consciousness.

Type II is strongly genetic in origin but lifestyle factors such as excess weight, inactivity, high blood pressure and poor diet are major risk factors for its development. Symptoms may not show for years and, by the time they appear, significant problems may have developed. It’s the most severe disease. It can be hidden from 7 to 11 years and then appear as absolutely another disease, like a heart attack, blindness, gangrene etc.

On February 15 the Government made changes in the State Health Protection Programme for 2011. These changes envisage a voucher system for everybody who benefits from state programmes. Professor Koba Amirkhanashvili, President of the Diabetic Children’s Protection Association, told The FINANCIAL that the new system has caused serious problems for diabetic children.

“Since 2005-2006 diabetes has been appearing more in males than in females,” noted Amirkhanashvili. “In 2006 out of newly registered diabetic children 52 were boys and 33 girls. The statistic was almost the same in 2010. Out of 49 children with diabetes 30 are boys.” Unfortunately the exact cause of diabetes in the children is unknown. Statistics show that in winter, due to the H1N1 virus, the number of diabetic children significantly increased.

“The most serious risk factor is the increase of the HLA antivirus in the body. As a rule in winter flu and viruses are more active than at other times of the year,” noted Amirkhanashvili. “After the August War in 2008 the number of children with Diabetes significantly increased, especially in regions close to the conflict zone. Diabetes of Type I can easily be triggered by diet as well. Unhealthy food with chemical elements and many calories can cause obesity. Obesity increases the risk of diabetes appearing by 66%.”

Corresponding to the risk factors the best prevention is actual control and regulation of nourishment. In addition parents should pay great attention to flu-like symptoms and take immediate treatment measures. When suffering from flu any kind of vaccination is especially forbidden, in order not to add viruses to the body.

Diabetes is an incurable disease. But it can be managed and the patient can live a long life. Regular treatment requires significant financial spendings. Regular examination of blood and organs, which is recommended to do a minimum of every two months, costs from 300 USD on average at the Georgian Diabetes Centre. Blood glucose monitoring systems such as Accu-Chek cost 50 USD in Tbilisi , 50 pieces of test strips - 30 USD. Since 1996 the Georgian Government has been implementing a programme which envisages the financial maintenance of diabetic children under 18 and pensioners up to 60 at the expense of the State Budget.

“We have two programmes. The first programme envisages maintenance, to manage diabetes in children under 18 and young adults,” explained Lela Tsotsoria, Senior Specialist of the Department of Public Health Programme. “Patients can get an endocrinology service, laboratory analysis, visit an ophthalmologist and get medical education courses free of charge. For each patient the budget envisages 508 GEL. According to the second programme, babies under 3 and pensioners up to 60 can use special dispensary help. Patients in a diabetic coma can use hospital treatment for three days. In addition Insulin is free for every diabetic.” As Amirkhanashvili complained, changes in these programmes, which are connected to too many documents, have caused a serious deficit of medicines.

"The changes were badly organized. The contracts weren’t signed in a timely manner. That caused a late supply of the medicines. If we didn’t have our own stock, it could have led to drastic results. I’m proud that since our establishment in 1996, no single child has died because of diabetes in Georgia. In other post soviet countries there is still 7-8% mortality data due to the disease". According to Professor Ramaz Khurashvili, President of the Georgian Diabetes Centre, by 2010 9.2% of the Georgian population had diabetes. In 2000 the percentage was only 7.3%.

“These days about half a million of the Georgian population has diabetes. Since 2000 we have been 36th in the statistics of the International Diabetes Federation,” noted Khurashvili. “The disease is growing faster than was expected. By the beginning of the ‘90s there were 150 million diabetics worldwide. Their number was expected to increase to 200 million. But the data boosted to 350,000,000 unexpectedly.”

Elena Shelestova, Board Member of the International Diabetes Federation also agrees that the number of diabetics has been rapidly increasing in recent times. “80% suffer from type II and the remaining 20% has diabetes type I,” noted Shelestova. “Scientists suppose that their number will hike to half a billion by 2030. Several other diseases can arise from diabetes as well. But unfortunately there are no statistics of which and how many diseases are caused by having diabetes, e.g. how many people needed leg amputations and how many diabetics have had heart attacks.”

There is one more type of Diabetes disease - Gestational diabetes mellitus (GDM). It is first diagnosed during pregnancy. Risk factors for GDM include a family history of diabetes, increasing maternal age, obesity and being a member of a community or ethnic group with a high risk of developing type II diabetes. The diabetes may absolutely disappear after childbirth. It may disappear but appear again after several years. The diabetes may cause some complications during childbirth as well. There is a high risk of either the mother or child dying.

Please call the Foot, Ankle & Lower Leg Center office anytime @702-878-2455 between Monday – Friday and we would be happy to set up an appointment for you. Please visit our website @ www.FallCenter.com or www.walkwithdiabetes.com The Foot, Ankle & Lower Leg Center has Diagnostic imaging: Digital X-Rays, Ultrasound or Advanced Imaging will be used to aid in the diagnosis.

Thursday, June 2, 2011

Do's and Don'ts for Fabulous Summer Feet

Do’s and Don’ts for Fabulous Summer Feet

Posted by: Care2 Healthy and Green Living

Almost 50 percent of women ages 18-49 say they received a professional pedicure before their 25th birthday, according to the American Podiatric Medical Association (APMA).

“Pampering and grooming your feet promotes good foot hygiene and should be done frequently to contribute to not only your foot health, but also to your body’s overall health,” says Dr. Marlene Reid, a podiatrist.

The APMA developed a tip sheet for pedicure do’s and don’ts and, since summer is the height of pedicure season, it’s a timely reminder for those who do get pedicures.

Pedicure Medical Alert
If you have diabetes or poor circulation in your feet, consult a podiatrist so they can recommend a customized pedicure that both you and your salon can follow for optimal foot health.

Pedicure Do’s

DO schedule your pedicure first thing in the morning. Salon foot baths are typically cleanest earlier in the day. If you’re not a morning person, make sure that the salon filters and cleans the foot bath between clients.
DO bring your own pedicure utensils to the salon. Bacteria and fungus can move easily from one person to the next if the salon doesn’t use proper sterilization techniques.
When eliminating thick, dead skin build-up, also known as calluses, on the heel, ball and sides of the feet, DO use a pumice stone, foot file or exfoliating scrub. Soak feet in warm water for at least five minutes then use the stone, scrub or foot file to gently smooth calluses and other rough patches.
When trimming nails, DO use a toenail clipper with a straight edge to ensure your toenail is cut straight across. Other tools like manicure scissors or fingernail clippers increase the risk of ingrown toenails because of their small, curved shape. See a podiatrist if you have a tendency to develop ingrown toenails.
To smooth nail edges, DO use an emery board. File lightly in one direction without using too much pressure, being sure not to scrape the nail’s surface.
DO gently run a wooden or rubber manicure stick under your nails to keep them clean. This helps remove the dirt and build-up you may or may not be able to see.
DO maintain the proper moisture balance of your feet’s skin by applying emollient-enriched moisturizer to keep soles soft.
DO use a rubber cuticle pusher or manicure stick to gently push back cuticles.
If toenails are healthy, DO use nail polish to paint toenails. Make sure to remove polish regularly using non-acetone nail polish remover.

Pedicure Don’ts

DON’T shave your legs before receiving a pedicure. Freshly shaven legs or small cuts on your legs may allow bacteria to enter.
If you are receiving a pedicure and manicure, DON’T use the same tools for both services as bacteria and fungus can transfer between fingers and toes.
DON’T allow technicians to use a foot razor to remove dead skin. Using a razor can result in permanent damage if used incorrectly and can easily cause infection if too much skin is removed.
DON’T round the edges of your toenails. This type of shape increases the chances that painful ingrown toenails will develop.
Emery boards are extremely porous and can trap germs that spread. Since they can’t be sterilized, DON’T share nail files with friends and be sure to bring your own to the salon, unless you are sure that the salon replaces them with each customer.
DON’T use any sharp tools to clean under nails. Using anything sharp makes it easy to puncture the skin, leaving it vulnerable to infection.
DON’T leave any moisture between toes. Anything left behind can promote the development of athlete’s foot or a fungal infection.
Because cuticles serve as a protective barrier against bacteria, DON’T ever cut them. Cutting cuticles increases the risk of infection. Also, avoid incessantly pushing back cuticles, as doing so can make them thicker.
If you suffer from thick and discolored toenails, which could be a sign of a fungal infection, DON’T apply nail polish to cover up the problem. Nail polish locks out moisture and doesn’t allow the nail bed to “breathe.” Once you fix the underlying issue, then it is safe to paint nails. If the problem persists be sure to visit your podiatrist.

Please call the Foot, Ankle & Lower Leg Center office anytime @702-878-2455 between Monday – Friday and we would be happy to set up an appointment for you. Please visit our website @ www.FallCenter.com or www.walkwithdiabetes.com The Foot, Ankle & Lower Leg Center has Diagnostic imaging: Digital X-Rays, Ultrasound or Advanced Imaging will be used to aid in the diagnosis.