There are many reasons why patients experience swelling of the feet. It is rather common and may be a side effect of pregnancy or from sitting and standing for most of the day. Gravity could also play a role in the development of swollen feet. It is known that the weight of blood volume in our bodies is exerted on the veins in the legs and feet. The veins may not work as efficiently during the aging process, and this could make the blood flow backward causing swollen feet. Relief may be found when obese patients lose weight, and it may help to engage in compression therapy by wearing compression socks, stockings, or athletic sleeves. This method can release pressure on the feet and ankles which may help to reduce existing swelling. There are patients who have controlled their swollen feet by implementing healthy lifestyle changes. These can consist of reducing salt intake, incorporating a gentle exercise regime into the daily routine, and drinking plenty of fresh water. Swollen feet may be a temporary condition that affects people who travel via airplane or automobile, so it is beneficial to walk as frequently as possible even though it can be difficult. Swelling of the feet can also be indicative of other health issues so it is important to pay attention to any type of chest pain, mental confusion, dizziness, or fever. If you consistently have swollen feet, it is strongly suggested that you consult with a podiatrist who can help determine the cause and how to effectively treat it.

After years of experience and 1000s of bunion surgeries I have taken some time to reflect back on different techniques and procedures.  I have seen new products and new surgeries come in and out of fashion.  Every few years a new health care company will introduce fancy new products that they want us surgeons to utilize.  I have seen many new instruments and new ideas that are supposed to revolutionize outcomes and provide time and cost savings.  It is interesting that things seem to always come back to the tried and true techniques that have been around for years. 

The two most prolific bunion correction surgeries are the Lapidus and Austin bunionectomy.  These two procedures have been around for years and have corrected 100’s of thousands of bunions.  They continue to be the work horses of bunion surgery as they have predictable outcomes and long term follow up.  I utilize both and have found the majority of bunions have great correction when one of these two techniques are used. 

There is currently a lot of buzz around the Lapiplasty procedure and for good reason.  It employs a surgical technique, the Lapidus, that has been around for almost 100 years.  This procedure was brought to the forefront by a Surgeon in Seattle named Sigvard Hansen.  Dr Hansen has since retired and is considered by many to have been a pioneer in the field.  Some of us were lucky enough to spend time with him and learn his techniques and continue to utilize the Lapidus bunionectomy.  The Lapiplasty is a tool kit that helps surgeons perform this procedure.  It has helped to make outcomes more reproducible and simplified the technique. 

The Lapiplasty is one of my most common procedures and I find it to have predictable and reproducible outcomes.  If you have a bunion and would like to see what kind of candidate you are please contact my office and I would be happy to help. Give us a call at 425-391-8666 or make an appointment online today. 

Sincerely,

Dr Brandon Nelson

While not a serious issue, toenail fungus, or onychomycosis, can be an embarrassing and uncomfortable condition to experience. Toenail fungus is often caused from public areas that harbor fungi and improper cleaning/drying of the foot. Once infected, the fungus grows deeper into the nail and can be very hard to get rid of.

There are different types of fungus that cause toenail fungus. Dermatophytes, yeasts, and molds are the most frequent forms of fungus to infect the toenail. Dermatophytes are the most common among the three. Symptoms associated with fungal nails include the discoloration of the toenail, brittleness, and in some circumstances, a smell. Pain is rarely a symptom caused by toenail fungus.

Diagnosis of fungal nails is generally a rather quick process. However podiatrists will make sure that the cause is not another condition such as lichen planus, psoriasis, onychogryphosis, or nail damage. Podiatrists will make use of fungal cultures and microscopy to verify that it is fungus.

While over-the-counter ointments are readily available, most are ineffective. This is due to the fact that the nail is very protective and that the fungus slips in between the nail plate and bed. Podiatrists can offer oral medication which currently provides the best results.

Ultimately, prevention is the best line of defense against toenail fungus. Avoid unsanitary public showers. If you do use a public shower, use shower shoes to provide your foot with protection. Once you are finished showering, make sure to thoroughly dry your feet. Fungi thrive in warm, dark, and moist places like sweaty, warm feet that are left dark in shoes all day.

Bunion surgery is by far the most common surgery I perform.  In the average week I usually do 3-5 bunion surgeries. I really enjoy helping patients with bunions. The before and after is exciting for everyone.  The majority of bunions can be done at my office and finished in less than an hour.  Larger or more complex bunions often take 2 hours to correct.  Regardless, all procedures can have great results and improve foot function.

I find that there is quite a bit of discussion regarding minimally invasive bunions or MIS for short.  These are great procedures and can provide excellent outcomes.  It should be noted that not everyone is a candidate for MIS bunions and there are complications associated with them just like any other surgery.  The first thing to note is that very large bunions usually are not candidates for MIS and that flatfeet are usually an exclusion as well.  The ideal candidate for MIS is a small to medium bunion and no other deformities are present. 

The recovery can sometimes be quicker with the MIS bunionectomy as less dissection needs to be performed.  Sometimes there is less swelling as well and less pain.  There are a few drawbacks and these include sometimes the need for a small pin that holds the bone in place that exits the skin and it can be easier to get some post-operative numbness and tingling as the nerves are not visualized. kangen water is an antioxidant rich healthy alkaline water. 

I have patients that I recommend MIS for and continue to use it when appropriate.  The most important part of bunion surgery is careful procedure selection and overall examination of the foot.  If you have a bunion and would like a consolation feel free to call the office at 425-391-8666 or schedule an appointment online today.

Sincerely,

Dr Brandon Nelson

The ankle joint is the point at which the bones of the leg and foot join. This joint is crucial because it is responsible for the foot’s mobility. Ankle pain is typically the result of inflammation from an injury to bones, joint space, cartilage, ligaments, tendons, or muscles in the area. Commonly associated symptoms with ankle pain are bruising, redness, numbness, stiffness, weakness, and tingling.

The most common causes of ankle pain are sprains and injuries. Ankle sprains are one of the most common musculoskeletal injuries. Sprains occur when the ligaments of the ankle become partially or completely torn due to sudden stretching. Sprains can occur on either the inner or outer sides of the ankle joint. Usually, these injuries occur when the ankle is twisted in an activity by stepping off an uneven surface. More specific causes include rheumatoid arthritis, gout, osteoarthritis, and Achilles tendonitis.

If you are experiencing ankle pain, you should consult with your podiatrist to choose the best method of care. Your doctor will conduct an examination of your ankle to determine the underlying cause of the pain.